Active NPI
Jon Wanya Hamilton, LCSWA
- Clinical Social Worker
- Charlotte, NC
National Provider Identifier
1114645462
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- P018138
- Practice address
- 5200 Park Rd Ste 218B
Charlotte, NC 28209-3650 - Phone
- (866) 700-1606
- NPI assigned
- Aug 22, 2022
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | P018138 | NC | Primary |
Addresses
Primary practice location
5200 Park Rd Ste 218B
Charlotte, NC 28209-3650
Mailing address
PO Box 8879
Asheville, NC 28814-8879
Phone (866) 700-1606
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P018138 | NC | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sparc Network | Clinical | Past | Accepting new patients |
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": "1661126400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1661126400000",
"number": "1114645462",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 8879",
"city": "ASHEVILLE",
"state": "NC",
"postal_code": "288148879",
"telephone_number": "866-700-1606"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5200 PARK RD STE 218B",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282093650",
"telephone_number": "866-700-1606"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAMILTON",
"first_name": "JON",
"middle_name": "WANYA",
"credential": "LCSWA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-08-22",
"last_updated": "2022-08-22",
"certification_date": "2022-08-22",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NC",
"license": "P018138",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.