Individual provider Active NPI

Kami Hamilton, RD, LD

  • Registered Dietitian
  • Tualatin, OR
National Provider Identifier
1013401389
Registry record updated Apr 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
LD-D-000659 Issued in OR
Practice address
6475 SW Borland Rd Ste F
Tualatin, OR 97062-9708
Phone
(503) 692-7617
NPI assigned
Jun 19, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Health Educator 174H00000X
Registered Dietitian 133V00000X LD-D-000659 OR Primary

Addresses

Primary practice location

6475 SW Borland Rd Ste F
Tualatin, OR 97062-9708

Mailing address

1040 NW 22ND Ave Ste 520
Portland, OR 97210-3097
Phone (503) 413-7557

Other identifiers 1

IdentifierTypeStateIssuer
LD-D-000569OtherORLICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LD-D-000659ORMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Good Samaritan Hospital and Medical Center Past Accepting new patients
Legacy Meridian Park Hospital Past Accepting new patients
Legacy Meridian Park Hospital Past Accepting new patients

Networks

  • devoted network organization-83621310-88c0-4660-8f8d-b8ea8f4dc04e
  • WA PPO C-SNP

Organizations & group practices 3

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": "1529366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555891200000",
    "number": "1013401389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 NW 22ND AVE STE 520",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972103097",
            "telephone_number": "503-413-7557",
            "fax_number": "503-413-6547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6475 SW BORLAND RD STE F",
            "city": "TUALATIN",
            "state": "OR",
            "postal_code": "970629708",
            "telephone_number": "503-692-7617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMILTON",
        "first_name": "KAMI",
        "credential": "RD, LD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-19",
        "last_updated": "2019-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174H00000X",
            "taxonomy_group": "",
            "desc": "Health Educator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "OR",
            "license": "LD-D-000659",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "LD-D-000569",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tualatin, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2019; 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.