Active NPI
Amanda Hamilton, AUD
- Audiologist
- Grand Rapids, MI
National Provider Identifier
1073353637
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 1601001153
- Practice address
- 901 Gezon Pkwy SW Ste a
Grand Rapids, MI 49509-9564 - Phone
- (616) 530-8883
- Fax
- (616) 530-8997
- NPI assigned
- May 30, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | 1601001153 | MI | Primary |
Addresses
Primary practice location
901 Gezon Pkwy SW Ste a
Grand Rapids, MI 49509-9564
Mailing address
901 Gezon Pkwy SW Ste a
Grand Rapids, MI 49509-9564
Phone (616) 530-8883
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1601001153 | MI | MD | Audiologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Audiology Distribution, LLC | Current | Accepting new patients |
Locations
102 S 3rd St
Ste 200
Carson City, MI 48811
Phone (989) 584-6217
221 E Maple St
Carson City, MI 48811
Phone (989) 584-3153
Organizations & group practices 1
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": "1717027200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1717027200000",
"number": "1073353637",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "901 GEZON PKWY SW STE A",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495099564",
"telephone_number": "616-530-8883",
"fax_number": "616-530-8997"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "901 GEZON PKWY SW STE A",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495099564",
"telephone_number": "616-530-8883",
"fax_number": "616-530-8997"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAMILTON",
"first_name": "AMANDA",
"credential": "AUD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-05-30",
"last_updated": "2024-05-30",
"certification_date": "2024-05-30",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "MI",
"license": "1601001153",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.