NPIMap

Organization Active NPI

Hopebridge LLC

  • Child & Adolescent Psychiatry Physician
  • Fort Myers, FL
National Provider Identifier
1548833619
Registry record updated Jul 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
Legal business name
HOPEBRIDGE LLC
Practice address
4150 Ford St Ste 4
Fort Myers, FL 33916-9498
Phone
(855) 234-0885
NPI assigned
Jul 19, 2021
Last updated
Jul 19, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
HOPEBRIDGE LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 19, 2021

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

Authorized official

Name
Angie Graff
Title
Contracting/Credentialing Manager
Phone
(317) 376-8336

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X NU
Clinical Psychologist 103TC0700X NU
Health Service Psychologist 103TH0100X NU
Child & Adolescent Psychiatry Physician 2084P0804X NU Primary
Behavior Analyst 103K00000X NU
Assistant Behavior Analyst 106E00000X NU
Behavior Technician 106S00000X NU

Addresses

Primary practice location

4150 Ford St Ste 4
Fort Myers, FL 33916-9498

Mailing address

3500 Depauw Blvd Ste 3070
Indianapolis, IN 46268-6135

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 18

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

View all 18

Locations

4150 Ford St
Ste 4
Fort Myers, FL 33916
Phone (239) 291-5088

1120 Medical Center Dr
Wilmington, NC 28401
Phone (910) 756-3447

Practitioners & affiliated clinicians

Practitioners 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1626652800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626652800000",
    "number": "1548833619",
    "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": "4150 FORD ST STE 4",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339169498",
            "telephone_number": "855-234-0885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOPEBRIDGE LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HOPEBRIDGE LLC",
        "enumeration_date": "2021-07-19",
        "last_updated": "2021-07-19",
        "certification_date": "2021-07-19",
        "status": "A",
        "authorized_official_last_name": "GRAFF",
        "authorized_official_first_name": "ANGIE",
        "authorized_official_title_or_position": "CONTRACTING/CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "317-376-8336"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2021; 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.