Provider Demographics
| NPI: | 1356674162 |
|---|---|
| Name: | TOTAL CARE FAMILY PRACTICE RICK BOBAY LLC |
| Entity type: | Organization |
| Organization Name: | TOTAL CARE FAMILY PRACTICE RICK BOBAY LLC |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | OWNER |
| Authorized Official - Prefix: | MR |
| Authorized Official - First Name: | RICHARD |
| Authorized Official - Middle Name: | J |
| Authorized Official - Last Name: | BOBAY |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | ARNP |
| Authorized Official - Phone: | 812-284-2273 |
| Mailing Address - Street 1: | 1701 SPRING ST STE B |
| Mailing Address - Street 2: | |
| Mailing Address - City: | JEFFERSONVILLE |
| Mailing Address - State: | IN |
| Mailing Address - Zip Code: | 47130-2930 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 812-284-2273 |
| Mailing Address - Fax: | 812-284-2279 |
| Practice Address - Street 1: | 1701 SPRING ST |
| Practice Address - Street 2: | SUITE B |
| Practice Address - City: | JEFFERSONVILLE |
| Practice Address - State: | IN |
| Practice Address - Zip Code: | 47130-2930 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 812-284-2273 |
| Practice Address - Fax: | 812-284-2279 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2009-09-10 |
| Last Update Date: | 2025-01-30 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Licenses
| State | License ID | Taxonomies |
|---|---|---|
| 2084A0401X, 261QM0801X, 363L00000X, 363LA2200X, 207Q00000X, 363LG0600X, 363LP0808X, 363LP2300X, 207R00000X | ||
| IN | 71002305A | 363LG0600X, 363LF0000X |
| KY | 3005827 | 363LF0000X |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | Group - Multi-Specialty | |
| No | 2084A0401X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Addiction Medicine | Group - Multi-Specialty |
| No | 261QM0801X | Ambulatory Health Care Facilities | Clinic/Center | Mental Health (Including Community Mental Health Center) | Group - Multi-Specialty |
| No | 363L00000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Group - Multi-Specialty | |
| No | 363LA2200X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health | Group - Multi-Specialty |
| No | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | Group - Multi-Specialty | |
| No | 363LG0600X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Gerontology | Group - Multi-Specialty |
| No | 363LP0808X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psychiatric/Mental Health | Group - Multi-Specialty |
| No | 363LF0000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | Group - Multi-Specialty |
| No | 363LP2300X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Primary Care | Group - Multi-Specialty |
Provider Identifiers
| State | Identifier ID | ID Type | Issuer |
|---|---|---|---|
| IN | 300087936 | Medicaid | |
| OH | 0079980 | Medicaid | |
| IN | 300054861 | Medicaid | |
| KY | 7100453010 | Medicaid | |
| MD | 557079400 | Medicaid | |
| IN | 000000642065 | Other | ANTHEM |
| IN | 200964180 | Medicaid | |
| IN | 300083386 | Medicaid | |
| IN | 300058981 | Medicaid | |
| IN | 300059153 | Medicaid |
