Individual provider Active NPI

Hailey Hamilton, FNP-C

  • Family Nurse Practitioner
  • Hattiesburg, MS
National Provider Identifier
1073350484
Registry record updated Jul 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
906750 Issued in MS
Practice address
2200 Hardy St Ste 30
Hattiesburg, MS 39401-5928
Phone
(601) 318-0669
NPI assigned
Jul 12, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2024

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 906750 MS Primary

Addresses

Primary practice location

2200 Hardy St Ste 30
Hattiesburg, MS 39401-5928

Mailing address

412 Holmes Rd
Jayess, MS 39641-7350
Phone (601) 455-6346

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20241009000221 MS Practitioner - Nurse Practitioner 6901337302 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Systems Management, LLCGroup PAC ID 5092964643, 49 clinicians

Practice addresses (Care Compare)

129 Ctr St
Suite B
Richland, MS 39218-4800
Phone (769) 233-7141

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
906750MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Systems Management LLC CurrentSince Aug 26, 2024 Accepting new patients
Ap Med L L C Family CurrentSince Jul 21, 2024 Accepting new patients

Locations

2200 Hardy St
Ste 30
Hattiesburg, MS 39401
Phone (601) 318-0669

129 Center St
Ste B
Richland, MS 39218
Phone (769) 233-7141

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.

Hospital & facility affiliations 2

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": "1720742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720742400000",
    "number": "1073350484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "412 HOLMES RD",
            "city": "JAYESS",
            "state": "MS",
            "postal_code": "396417350",
            "telephone_number": "601-455-6346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 HARDY ST STE 30",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394015928",
            "telephone_number": "601-318-0669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMILTON",
        "first_name": "HAILEY",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-12",
        "last_updated": "2024-07-12",
        "certification_date": "2024-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "906750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hattiesburg, MS

Sources for this page

Verify at the official NPI Registry.