Individual provider Active NPI

Amanda Hamilton, AUD

  • Audiologist
  • Grand Rapids, MI
National Provider Identifier
1073353637
Registry record updated May 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
1601001153 Issued in MI
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

Updated by the provider on May 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

Enrollment IDStateProvider typePAC IDDetails
I20240627003446 MI Practitioner - Qualified Audiologist 6103360441 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1601001153MIMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Audiology Distribution, LLC CurrentSince Mar 2, 2026 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.

Verify at the official NPI Registry.