Individual provider Active NPI

Kelly Marie Hamilton, M.D.

  • Obstetrics & Gynecology Physician
  • Midland, MI
National Provider Identifier
1033390646
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
390200000X Issued in NC
Practice address
4401 Campus Ridge Dr Ste Ll110
Midland, MI 48640-6126
Phone
(989) 837-9400
Fax
(989) 837-9410
NPI assigned
Nov 26, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 390200000X NC Primary

Addresses

Primary practice location

4401 Campus Ridge Dr Ste Ll110
Midland, MI 48640-6126

Mailing address

4401 N Campus Ridge Dr
Ste B2200
Midland, MI 48640-6112
Phone (989) 837-9400

Other identifiers 1

IdentifierTypeStateIssuer
4301099687OtherMIST LIC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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

Enrollment IDStateProvider typePAC IDDetails
I20111020000331 MI Practitioner - Obstetrics/Gynecology 7810169653 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Toledo Medical College, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mymichigan Medical Center MidlandGroup PAC ID 2264323633, 507 clinicians

Practice addresses (Care Compare)

4000 Wellness Dr
Midland, MI 48670-2000
Phone (989) 633-8018

4500 Campus Ridge Dr
Midland, MI 48640-6123
Phone (989) 837-9250

602 Beech St
Clare, MI 48617-1466
Phone (989) 488-5420

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
390200000XNCMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mymichigan Medical Center Midland CurrentSince Apr 4, 2019 Accepting new patients
Mymichigan Medical Center Midland CurrentSince Apr 4, 2019 Accepting new patients
Mymichigan Medical Group PastSince Jul 24, 2022 Accepting new patients
Mymichigan Medical Center Midland Past Accepting new patients

Locations

602 Beech St
Ste 3100
Clare, MI 48617
Phone (989) 802-5020

815 N Clare Ave
Harrison, MI 48625
Phone (989) 539-4096

4401 N Campus Ridge Dr
Ste B2200
Midland, MI 48640
Phone (989) 837-9400

4000 Wellness Dr
Midland, MI 48670
Phone (844) 832-1956

4500 N Campus Ridge Dr
Midland, MI 48640
Phone (989) 837-9250

4401 N Campus Ridge Dr
Ste LL110
Midland, MI 48640
Phone (989) 837-9400

Interoperability endpoints

  • Direct secure messaging: khamilton5896@mymichiganhealth.midirect.net

Organizations & group practices 4

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1196035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1033390646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4401 N CAMPUS RIDGE DR",
            "address_2": "STE B2200",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486406112",
            "telephone_number": "989-837-9400",
            "fax_number": "989-837-9410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 CAMPUS RIDGE DR STE LL110",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486406126",
            "telephone_number": "989-837-9400",
            "fax_number": "989-837-9410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMILTON",
        "first_name": "KELLY",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-26",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NC",
            "license": "390200000X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ST LIC",
            "identifier": "4301099687",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Midland, MI

Sources for this page

Verify at the official NPI Registry.