NPIMap

Individual provider Active NPI

Lance Lee Hamilton, M.D.

  • Internal Medicine Physician
  • Bentonville, AR
National Provider Identifier
1053309898
Registry record updated Dec 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
N8166 Issued in AR
Practice address
2618 SE J St
Ste 12
Bentonville, AR 72712-3857
Phone
(479) 715-6505
Fax
(479) 340-0015
NPI assigned
Oct 6, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X N8166 AR Primary

Addresses

Primary practice location

2618 SE J St
Ste 12
Bentonville, AR 72712-3857

Mailing address

2618 SE J St
Ste 12
Bentonville, AR 72712-3857
Phone (479) 715-6505

Other identifiers 3

IdentifierTypeStateIssuer
121148001MedicaidAR
121148801MedicaidAR
100125440AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040623001498 AR Practitioner - Internal Medicine 1658356456 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Oklahoma College of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Springdale Bentonville HBP Services LLCGroup PAC ID 1052759263, 88 clinicians

Practice addresses (Care Compare)

3000 Medical Ctr Pkwy
Bentonville, AR 72712-3217
Phone (479) 553-1000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
N8166ARMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bentonville Medical Arts PLLC Internal Medicine CurrentSince Apr 15, 2016 Accepting new patients
Springdale- Bentonville HBP Services, LLC CurrentSince May 3, 2024 Accepting new patients
Ies HSP Arkansas PLLC CurrentSince Jan 1, 2023 Accepting new patients
Sparks Medical Foundation Past Accepting new patients
Sparks Medical Foundation Internal Medicine Past Accepting new patients
Sparks Regional Medical Center Past Accepting new patients
Advanced Aesthetics & Wellness Center PA, Earlmd Family Medicine PA Past Accepting new patients
Fort Smith Hma, LLC Past Accepting new patients
Northwest Arkansas Hospitals, LLC Past Accepting new patients

Locations

3000 Medical Center Pkwy
Bentonville, AR 72712
Phone (479) 553-2524

2618 SE J St
Ste 12
Bentonville, AR 72712
Phone (479) 367-2866

3873 N Parkview Dr
Fayetteville, AR 72703
Phone (479) 527-0050

603 N Progress Ave
Siloam Springs, AR 72761
Phone (479) 215-3000

609 W Maple Ave
Springdale, AR 72764
Phone (479) 751-5711

Interoperability endpoints

  • Direct secure messaging: lance.hamilton@133671.advancedmd-direct.com

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Promenade Health and RehabilitationRogers, AR, CCN 045361 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Mar 1, 2018
Mar 1, 2018
Siloam Healthcare LLCSiloam Springs, AR, CCN 045356 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jun 1, 2018
Jun 1, 2018

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 9

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 10

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": "1128556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576540800000",
    "number": "1053309898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2618 SE J ST",
            "address_2": "STE 12",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727123857",
            "telephone_number": "479-715-6505",
            "fax_number": "479-340-0015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2618 SE J ST",
            "address_2": "STE 12",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727123857",
            "telephone_number": "479-715-6505",
            "fax_number": "479-340-0015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMILTON",
        "first_name": "LANCE",
        "middle_name": "LEE",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-06",
        "last_updated": "2019-12-17",
        "certification_date": "2019-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AR",
            "license": "N8166",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "121148001",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "121148801",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100125440A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bentonville, AR

Sources for this page

Verify at the official NPI Registry.