NPIMap

Organization Active NPI

Community Bridges, Inc

Doing business as Globe SRU & Outpatient Clinic

  • Clinical Medical Laboratory
  • Globe, AZ
National Provider Identifier
1821345752
Registry record updated Aug 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
03D2036585 Issued in AZ
Legal business name
COMMUNITY BRIDGES, INC
Doing business as
Globe SRU & Outpatient Clinic
Practice address
5734 East Hope Lane
Globe, AZ 85501
Phone
(928) 425-2415
Fax
(928) 425-2464
NPI assigned
Aug 9, 2012
Last updated
Aug 9, 2012By the provider in NPPES
Organization subpart
Yes
Parent organization
COMMUNITY BRIDGES, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 9, 2012

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

Authorized official

Name
Mr. John Hogeboom, LISAC
Title
VP/Coo
Phone
(480) 831-7566

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 03D2036585 AZ Primary

Addresses

Primary practice location

5734 East Hope Lane
Globe, AZ 85501

Mailing address

1855 W Baseline Rd
Suite 101
Mesa, AZ 85202-9000
Phone (480) 831-7566

Other names 1

  • Globe SRU & Outpatient Clinic Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
03D2036585Community Bridges, Inc5734 E Hope Lane, Suite 1, Globe, AZ 85501Certificate of waiverFeb 8, 2028

National Provider Directory

National Provider Directory
Tax ID family
Community Bridges66 organizations share this tax ID, including this one
Part of
Community Bridges

Organizations with this tax ID in the same state 24

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

View all 24

Practitioners & affiliated clinicians

Practitioners 3

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": "1344470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1344470400000",
    "number": "1821345752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1855 W BASELINE RD",
            "address_2": "SUITE 101",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852029000",
            "telephone_number": "480-831-7566",
            "fax_number": "480-962-7176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5734 EAST HOPE LANE",
            "city": "GLOBE",
            "state": "AZ",
            "postal_code": "85501",
            "telephone_number": "928-425-2415",
            "fax_number": "928-425-2464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY BRIDGES, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COMMUNITY BRIDGES, INC",
        "enumeration_date": "2012-08-09",
        "last_updated": "2012-08-09",
        "status": "A",
        "authorized_official_last_name": "HOGEBOOM",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "VP/COO",
        "authorized_official_telephone_number": "480-831-7566",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LISAC"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "AZ",
            "license": "03D2036585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Globe SRU & Outpatient Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Globe, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.