Individual provider Active NPI

Emma Mary Hamilton, ARNP

  • Family Nurse Practitioner
  • Mount Vernon, WA
National Provider Identifier
1053075416
Registry record updated Oct 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP61256433 Issued in WA
Practice address
1420 Roosevelt Ave Ste 4
Mount Vernon, WA 98273-2687
Phone
(360) 899-4086
Fax
(360) 899-4124
NPI assigned
Oct 22, 2021
Last updated
Oct 16, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP61256433 WA Primary

Addresses

Primary practice location

1420 Roosevelt Ave Ste 4
Mount Vernon, WA 98273-2687

Mailing address

3553 Aldergrove Rd
Ferndale, WA 98248-8757
Phone (360) 393-2806

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231222001538 WA Practitioner - Nurse Practitioner 7113377748 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1420 Roosevelt Ave
Suite 4
Mount Vernon, WA 98273-2687
Phone (360) 899-4086

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP61256433WAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cascade Clinic Walk in and Primary Care LLC CurrentSince Oct 4, 2023 Accepting new patients
Premier Diabetes Care, PLLC PastSince Oct 4, 2023 Accepting new patients
Spring Arbor University Physical Therapy and Athletic Training LLC PastSince Oct 1, 2021 Accepting new patients
Spring Arbor University Student in an Organized Health Care Education/Training Program PastSince Oct 1, 2021 Accepting new patients

Locations

1420 Roosevelt Ave
Ste 4
Mount Vernon, WA 98273
Phone (360) 899-4086

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1634860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697414400000",
    "number": "1053075416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3553 ALDERGROVE RD",
            "city": "FERNDALE",
            "state": "WA",
            "postal_code": "982488757",
            "telephone_number": "360-393-2806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 ROOSEVELT AVE STE 4",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982732687",
            "telephone_number": "360-899-4086",
            "fax_number": "360-899-4124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMILTON",
        "first_name": "EMMA",
        "middle_name": "MARY",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-22",
        "last_updated": "2023-10-16",
        "certification_date": "2023-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP61256433",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, WA

Sources for this page

Verify at the official NPI Registry.