Individual provider Active NPI

Eunice Hamilton, RN, FNP-BC

  • Nurse Practitioner
  • Niles, MI
National Provider Identifier
1114196748
Registry record updated Nov 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704218867 Issued in MI
Practice address
1211 Stateline Rd
Niles, MI 49120-4729
Phone
(269) 684-2810
Fax
(248) 218-9996
NPI assigned
Feb 28, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4704218867 MI Primary

Addresses

Primary practice location

1211 Stateline Rd
Niles, MI 49120-4729

Mailing address

1211 Stateline Rd
Niles, MI 49120-4729
Phone (269) 684-2810

Other identifiers 1

IdentifierTypeStateIssuer
0877675OtherMIBCBSM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20090604000392 MI Practitioner - Nurse Practitioner 5698842888 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
4704218867MIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Vpa PC CurrentSince Aug 1, 2022 Accepting new patients
Iah of Michigan, PLLC CurrentSince Aug 1, 2022 Accepting new patients
Theoria Medical Nurse Practitioner CurrentSince Sep 16, 2023 Accepting new patients
Vpa PC Current Accepting new patients

Locations

1484 Straits Dr
Ste 5
Bay City, MI 48706
Phone (989) 667-8740

5655 Clarkston Rd
Clarkston, MI 48348
Phone (810) 623-5216

4444 W Bristol Rd
Ste 150
Flint, MI 48507
Phone (810) 230-9500

3139 E Baldwin Rd
Grand Blanc, MI 48439
Phone (810) 445-5300

1211 Stateline Rd
Niles, MI 49120
Phone (269) 684-2810

41800 W 11 Mile Rd
Ste 109
Novi, MI 48375
Phone (833) 578-2763

2205 Jolly Rd
Ste A
Okemos, MI 48864
Phone (517) 347-4085

2205 Jolly Rd
Ste B
Okemos, MI 48864
Phone (517) 347-4085

2725 Airview Blvd
Ste 105
Portage, MI 49002
Phone (269) 349-8386

500 Kirts Blvd
Ste 100
Troy, MI 48084
Phone (214) 824-6000

500 Kirts Blvd
Ste 200
Troy, MI 48084
Phone (248) 824-6060

Organizations & group practices 4

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": "1204156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699401600000",
    "number": "1114196748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 STATELINE RD",
            "city": "NILES",
            "state": "MI",
            "postal_code": "491204729",
            "telephone_number": "269-684-2810",
            "fax_number": "248-218-9996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 STATELINE RD",
            "city": "NILES",
            "state": "MI",
            "postal_code": "491204729",
            "telephone_number": "269-684-2810",
            "fax_number": "248-218-9996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMILTON",
        "first_name": "EUNICE",
        "credential": "RN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-28",
        "last_updated": "2023-11-08",
        "certification_date": "2023-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704218867",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "0877675",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Niles, MI

Sources for this page

Verify at the official NPI Registry.