Active NPI
Jack Bradley Hamilton
- Orthotic Fitter
- Clinton, NC
National Provider Identifier
1154936003
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthotic Fitter
- License
- CFT2031
- Practice address
- 408 Northeast Blvd
Clinton, NC 28328-2434 - Phone
- (910) 592-2343
- NPI assigned
- Sep 8, 2020
- 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 |
|---|---|---|---|---|
| Orthotic Fitter | 225000000X | CFT2031 | NC | Primary |
Addresses
Primary practice location
408 Northeast Blvd
Clinton, NC 28328-2434
Mailing address
408 Northeast Blvd
Clinton, NC 28328-2434
Phone (910) 592-2343
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | dme@matthewsdrugs.com |
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 |
|---|---|---|---|
| CFT2031 | NC | MD | Orthotic Fitter |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1599523200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1599523200000",
"number": "1154936003",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "408 NORTHEAST BLVD",
"city": "CLINTON",
"state": "NC",
"postal_code": "283282434",
"telephone_number": "910-592-2343"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "408 NORTHEAST BLVD",
"city": "CLINTON",
"state": "NC",
"postal_code": "283282434",
"telephone_number": "910-592-2343"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAMILTON",
"first_name": "JACK",
"middle_name": "BRADLEY",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-09-08",
"last_updated": "2020-09-08",
"certification_date": "2020-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "225000000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Orthotic Fitter",
"state": "NC",
"license": "CFT2031",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "dme@matthewsdrugs.com",
"affiliation": "N",
"address_1": "408 Northeast Blvd",
"city": "Clinton",
"state": "NC",
"country_code": "US",
"postal_code": "283282434",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Clinton, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.