NPIMap

Organization Active NPI

Hopebridge, LLC

  • Child & Adolescent Psychiatry Physician
  • Miamisburg, OH
National Provider Identifier
1326550781
Registry record updated Feb 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
Legal business name
HOPEBRIDGE, LLC
Practice address
9260 Marketplace Dr
Miamisburg, OH 45342-4478
Phone
(855) 324-0885
Fax
(765) 450-6664
NPI assigned
Oct 25, 2017
Last updated
Feb 20, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
HOPEBRIDGE, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 20, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Stephen Louis Dicarlo
Title
Credentialing Assistant Manager
Phone
(855) 324-0885

Specialties & licenses 11

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X
Clinical Psychologist 103TC0700X
Child & Adolescent Psychiatry Physician 2084P0804X Primary
Physical Therapist 225100000X
Pediatric Physical Therapist 2251P0200X
Occupational Therapist 225X00000X
Pediatric Occupational Therapist 225XP0200X
Speech-Language Pathologist 235Z00000X
Behavior Analyst 103K00000X
Assistant Behavior Analyst 106E00000X
Behavior Technician 106S00000X

Addresses

Primary practice location

9260 Marketplace Dr
Miamisburg, OH 45342-4478

Mailing address

3500 Depauw Blvd Ste 3070
Indianapolis, IN 46268-6135

Other practice location 1

3485 Newmark Dr
Miamisburg, OH 45342-5426
Phone (937) 388-5110

Other identifiers 1

IdentifierTypeStateIssuer
0265830MedicaidOH

National Provider Directory

National Provider Directory
Tax ID family
Hopebridge LLC119 organizations share this tax ID, including this one
Part of
Hopebridge LLC

Organizations with this tax ID in the same state 11

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

Locations

3485 Newmark Dr
Miamisburg, OH 45342
Phone (937) 388-5110

9260 Marketplace Dr
Miamisburg, OH 45342
Phone (937) 388-5110

Practitioners & affiliated clinicians

Practitioners 50

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 50

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1508889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676851200000",
    "number": "1326550781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 DEPAUW BLVD STE 3070",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462686135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9260 MARKETPLACE DR",
            "city": "MIAMISBURG",
            "state": "OH",
            "postal_code": "453424478",
            "telephone_number": "855-324-0885",
            "fax_number": "765-450-6664"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3485 Newmark Dr",
            "address_purpose": "LOCATION",
            "city": "Miamisburg",
            "state": "OH",
            "postal_code": "453425426",
            "country_code": "US",
            "telephone_number": "937-388-5110",
            "fax_number": "317-520-8200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "HOPEBRIDGE, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HOPEBRIDGE, LLC",
        "enumeration_date": "2017-10-25",
        "last_updated": "2023-02-20",
        "certification_date": "2023-02-20",
        "status": "A",
        "authorized_official_last_name": "DICARLO",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "LOUIS",
        "authorized_official_title_or_position": "CREDENTIALING ASSISTANT MANAGER",
        "authorized_official_telephone_number": "855-324-0885"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0265830",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miamisburg, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2023; 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.