Individual provider Active NPI

Martha Dickerson Hamilton, LCSW

  • Clinical Social Worker
  • Virginia Beach, VA
National Provider Identifier
1194885327
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
001652 Issued in VA
Practice address
613 North Lynn Haven Rd
Ste B
Virginia Beach, VA 23452-4419
Phone
(757) 486-6515
Fax
(757) 498-5452
NPI assigned
Dec 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 001652 VA Primary

Addresses

Primary practice location

613 North Lynn Haven Rd
Ste B
Virginia Beach, VA 23452-4419

Mailing address

3419 Virginia Beach Blvd
#B12
Virginia Beach, VA 23452-4419
Phone (757) 486-6515

Other identifiers 3

IdentifierTypeStateIssuer
0005638063OtherAETNA
023220OtherVALUE OPTIONS
330004OtherVAANTHEM BCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040329001336 VA Practitioner - Clinical Social Worker 7214829688 Practice locations: Virginia Beach, VA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2624 Southern Blvd
Suite 102
Virginia Beach, VA 23452-7433
Phone (757) 486-6515

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
001652VAMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194885327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3419 VIRGINIA BEACH BLVD",
            "address_2": "#B12",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234524419",
            "telephone_number": "757-486-6515",
            "fax_number": "757-498-5452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "613 NORTH LYNN HAVEN RD",
            "address_2": "STE B",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234524419",
            "telephone_number": "757-486-6515",
            "fax_number": "757-498-5452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMILTON",
        "first_name": "MARTHA",
        "middle_name": "DICKERSON",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "001652",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0005638063",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "023220",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "330004",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

Verify at the official NPI Registry.