Individual provider Active NPI

Keynan Hobbs, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • La Mesa, CA
National Provider Identifier
1346529823
Registry record updated Apr 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95019274 Issued in CA
Practice address
8900 Grossmont Blvd
Ste 4
La Mesa, CA 91941-4047
Phone
(858) 380-7691
NPI assigned
Aug 15, 2011
Last updated
Apr 26, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95019274 CA Primary

Addresses

Primary practice location

8900 Grossmont Blvd
Ste 4
La Mesa, CA 91941-4047

Mailing address

8900 Grossmont Blvd
Ste 4
La Mesa, CA 91941-4047
Phone (858) 380-7691

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221004000246 CA Practitioner - Nurse Practitioner 3678859253 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Brian P Miller Medical Doctor IncGroup PAC ID 4981049046, 8 clinicians
Brian P Miller MD a Professional CorporationGroup PAC ID 5597902437, 2 clinicians

Practice addresses (Care Compare)

5555 Grossmont Ctr Dr
La Mesa, CA 91942-3019
Phone (858) 939-4393

8851 Ctr Dr
Suite 200
La Mesa, CA 91942-3043
Phone (619) 597-7691

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Brian P. Miller, M.D., a Professional Corporation CurrentSince Aug 12, 2022 Accepting new patients
Brian P. Miller Medical Doctor Inc. Psychiatric/Mental Health CurrentSince Jan 1, 2024 Accepting new patients

Locations

5555 Grossmont Center Dr
La Mesa, CA 91942
Phone (619) 465-0711

7850 Vista Hill Ave
San Diego, CA 92123
Phone (858) 836-8434

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1313366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650931200000",
    "number": "1346529823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8900 GROSSMONT BLVD",
            "address_2": "STE 4",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919414047",
            "telephone_number": "858-380-7691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8900 GROSSMONT BLVD",
            "address_2": "STE 4",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919414047",
            "telephone_number": "858-380-7691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOBBS",
        "first_name": "KEYNAN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-15",
        "last_updated": "2022-04-26",
        "certification_date": "2022-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95019274",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Mesa, CA

Sources for this page

Verify at the official NPI Registry.