Individual provider Active NPI

Susan Chambers Hamilton, CPNP-PC

  • Pediatric Nurse Practitioner
  • Knightdale, NC
National Provider Identifier
1063901684
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
5010504 Issued in NC
Practice address
6602 Knightdale Blvd Ste 204
Knightdale, NC 27545-6567
Phone
(919) 782-5273
NPI assigned
May 9, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 5010504 NC
Pediatric Nurse Practitioner 363LP0200X 5010504 NC Primary

Addresses

Primary practice location

6602 Knightdale Blvd Ste 204
Knightdale, NC 27545-6567

Mailing address

2000 Perimeter Park Dr Ste 200
Morrisville, NC 27560-8442

Other practice location 1

3801 Computer Dr Ste 200
Raleigh, NC 27609-6506
Phone (919) 782-5273

Other identifiers 2

IdentifierTypeStateIssuer
246612OtherNCNCBON
5010504OtherNCNCBON

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address shamilton168615@direct.UNC.nchie.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20190219002706 NC Practitioner - Nurse Practitioner 4486992369 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5010504NCMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Unc Physicians Network LLC Pediatrics CurrentSince Dec 5, 2018 Accepting new patients
Unc Physicians Network LLC Current Accepting new patients

Locations

940 Martin Luther King Jr Blvd
Chapel Hill, NC 27514
Phone (919) 942-5123

6602 Knightdale Blvd
Ste 204
Knightdale, NC 27545
Phone (919) 782-5273

2000 Perimeter Park Dr
Ste 200
Morrisville, NC 27560
Phone (800) 594-8624

3801 Computer Dr
Ste 200
Raleigh, NC 27609
Phone (919) 782-5273

10831 Forest Pines Dr
Ste 100
Raleigh, NC 27614
Phone (919) 782-5273

Organizations & group practices 2

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": "1525824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1063901684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 PERIMETER PARK DR STE 200",
            "city": "MORRISVILLE",
            "state": "NC",
            "postal_code": "275608442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6602 KNIGHTDALE BLVD STE 204",
            "city": "KNIGHTDALE",
            "state": "NC",
            "postal_code": "275456567",
            "telephone_number": "919-782-5273"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3801 Computer Dr Ste 200",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "276096506",
            "country_code": "US",
            "telephone_number": "919-782-5273",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAMILTON",
        "first_name": "SUSAN",
        "middle_name": "CHAMBERS",
        "name_prefix": "Mrs.",
        "credential": "CPNP-PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-09",
        "last_updated": "2023-03-07",
        "certification_date": "2021-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "5010504",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NC",
            "license": "5010504",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCBON",
            "identifier": "246612",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCBON",
            "identifier": "5010504",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "shamilton168615@direct.UNC.nchie.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "6602 Knightdale Blvd Ste 204",
            "city": "Knightdale",
            "state": "NC",
            "country_code": "US",
            "postal_code": "275456567",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Knightdale, NC

Sources for this page

Verify at the official NPI Registry.