Ivan Bruce Hoffman, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

36396 Issued in GA

Practice address

4015 S Cobb Dr SE
Suite 220
Smyrna, GA 30080-6303

Phone

(770) 801-0980

Fax

(770) 801-9039

NPI assigned

Jul 5, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Personal Recovery Network LLC

  • Psychiatry Physician
  • Stockbridge, GA
  • NPI 1881990869
  Medicare reassignment NPD

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282176000000",
    "number": "1861423360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4015 S COBB DR SE",
            "address_2": "SUITE 220",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300806303",
            "telephone_number": "770-801-0980",
            "fax_number": "770-801-9039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4015 S COBB DR SE",
            "address_2": "SUITE 220",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300806303",
            "telephone_number": "770-801-0980",
            "fax_number": "770-801-9039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOFFMAN",
        "first_name": "IVAN",
        "middle_name": "BRUCE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-05",
        "last_updated": "2010-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "GA",
            "license": "36396",
            "primary": true
        },
        {
            "code": "2084A0401X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "GA",
            "license": "36396",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hintons Integrative Medicine Him LLC
• Erin Hintt
• HJ Health Agency, LLC
• Kevin Hoang
• Robert Stephen Hoff, D.M.D.
• Hold Fast
• Hold Fast Motion
• Holistics LTD. Co
• Kawonda Holland, RN, CADC II
• Jackie Holliday, LPC

• Psychiatry Physician in Smyrna, GA
• Providers in Smyrna, GA by specialty
• Psychiatry Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.