Ennoble HC Ky PLLC

Primary specialty

Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X

Legal business name

ENNOBLE HC KY PLLC

Practice address

2 University PLZ Ste 204
Hackensack, NJ 07601-6211

Phone

(551) 295-8223

NPI assigned

Jun 23, 2026

Organization subpart

No

Name

Mark Bradshaw, MD

Title

Owner

Phone

(678) 665-2618

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 23, 2026.

{
    "created_epoch": "1782172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782172800000",
    "number": "1275469488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 UNIVERSITY PLZ",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076016202",
            "telephone_number": "551-295-8223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 UNIVERSITY PLZ STE 204",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076016211",
            "telephone_number": "551-295-8223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENNOBLE HC KY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-06-23",
        "last_updated": "2026-06-23",
        "certification_date": "2026-06-23",
        "status": "A",
        "authorized_official_last_name": "BRADSHAW",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-665-2618",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristen Ennis, FNP-C
• Ennoble HC FL II LLC
• Ennoble HC FL III, LLC
• Ennoble HC Ky II PLLC
• Ennoble HC Ky III PLLC
• Ennoble HC Mso Holdco Inc
• Ennoble HC NJ II PC
• Ennoble HC NJ III PC
• Ennoble HC NJ PC
• Ennoble HC TX II PA

• All providers in Hackensack, NJ
• Geriatric Medicine (Family Medicine) Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.