Individual provider Active NPI

Jordan P Hobbs, CNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Rochester, MN
National Provider Identifier
1740663798
Registry record updated Jan 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
3965 Issued in MN
Practice address
1652 Greenview Dr SW Ste 160
Rochester, MN 55902-4326
Phone
(507) 328-0634
Fax
(612) 567-4497
NPI assigned
Jul 8, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 3965 MN Primary
Child & Adolescent Psychiatric/Mental Health Registered Nurse 163WP0807X CNP3965 MN

Addresses

Primary practice location

1652 Greenview Dr SW Ste 160
Rochester, MN 55902-4326

Mailing address

1652 Greenview Dr SW Ste 160
Rochester, MN 55902-4326
Phone (507) 328-0634

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20160210000495 MN Practitioner - Nurse Practitioner 5698079747 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3015 Allegro Park LN SW
Suite C
Rochester, MN 55902-4139
Phone (507) 328-0634

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
CNP3965MNMDChild & Adolescent Psychiatric/Mental Health Registered Nurse
3965MNMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
As You Are PLLC Psychiatric/Mental Health CurrentSince Jan 1, 2022 Accepting new patients

Locations

3015 Allegro Park Ln SW
Ste C
Rochester, MN 55902

1652 Greenview Dr SW
Ste 160
Rochester, MN 55902
Phone (507) 328-0634

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1436313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642377600000",
    "number": "1740663798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1652 GREENVIEW DR SW STE 160",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559024326",
            "telephone_number": "507-328-0634",
            "fax_number": "612-567-4497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1652 GREENVIEW DR SW STE 160",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559024326",
            "telephone_number": "507-328-0634",
            "fax_number": "612-567-4497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOBBS",
        "first_name": "JORDAN",
        "middle_name": "P",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-08",
        "last_updated": "2022-01-17",
        "certification_date": "2022-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MN",
            "license": "3965",
            "primary": true
        },
        {
            "code": "163WP0807X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Child & Adolescent",
            "state": "MN",
            "license": "CNP3965",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, MN

Sources for this page

Verify at the official NPI Registry.