Organization Active NPI

Hobson Psychiatric Services PC

  • Addiction Medicine (Psychiatry & Neurology) Physician
  • Fort Wayne, IN
National Provider Identifier
1861697989
Registry record updated Feb 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Psychiatry & Neurology) PhysicianTaxonomy code 2084A0401X
License
01029672A Issued in IN
Legal business name
HOBSON PSYCHIATRIC SERVICES PC
Practice address
2021 Hobson Rd
Fort Wayne, IN 46805-4872
Phone
(260) 483-3287
Fax
(260) 842-3820
NPI assigned
Jun 19, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2012

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

Authorized official

Name
Mr. Jay D Patel, MD
Title
Owner
Phone
(260) 483-3287

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X 39000054A IN
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X 34001106A IN
Addiction Medicine (Psychiatry & Neurology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084A0401X 01029672A IN Primary

Addresses

Primary practice location

2021 Hobson Rd
Fort Wayne, IN 46805-4872

Mailing address

2021 Hobson Rd
Fort Wayne, IN 46805-4872
Phone (260) 483-3287

Other identifiers 1

IdentifierTypeStateIssuer
100079870MedicaidIN

National Provider Directory

National Provider Directory

Locations

2021 Hobson Rd
Fort Wayne, IN 46805
Phone (219) 483-3287

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1182211200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1330387200000",
    "number": "1861697989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2021 HOBSON RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468054872",
            "telephone_number": "260-483-3287",
            "fax_number": "260-842-3820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2021 HOBSON RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468054872",
            "telephone_number": "260-483-3287",
            "fax_number": "260-842-3820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOBSON PSYCHIATRIC SERVICES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-19",
        "last_updated": "2012-02-28",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "JAY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "260-483-3287",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "39000054A",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34001106A",
            "primary": false
        },
        {
            "code": "2084A0401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "IN",
            "license": "01029672A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100079870",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2012; 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.