Active NPI
Courtney Claire Hamilton, MS, RD, L/DN
- Registered Dietitian
- Revere, MA
National Provider Identifier
1184864910
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 2678
- Practice address
- 205 Endicott Ave
Revere, MA 02151-4157 - Phone
- (330) 883-6408
- NPI assigned
- Mar 6, 2009
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 2678 | MA | Primary |
Addresses
Primary practice location
205 Endicott Ave
Revere, MA 02151-4157
Mailing address
205 Endicott Ave
Revere, MA 02151-4157
Phone (330) 883-6408
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
- Credentials
- Master of Science
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tag Virtual Wellness LLC | Dietitian, Registered | 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": "1236297600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1236297600000",
"number": "1184864910",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "205 ENDICOTT AVE",
"city": "REVERE",
"state": "MA",
"postal_code": "021514157",
"telephone_number": "330-883-6408"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "205 ENDICOTT AVE",
"city": "REVERE",
"state": "MA",
"postal_code": "021514157",
"telephone_number": "330-883-6408"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAMILTON",
"first_name": "COURTNEY",
"middle_name": "CLAIRE",
"credential": "MS, RD, L/DN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-03-06",
"last_updated": "2009-03-06",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "MA",
"license": "2678",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Revere, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.