Keith R. Hamm, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

046-009444 Issued in IL

Practice address

3248 Green Mount Crossing Dr
Shiloh, IL 62269-7284

Phone

(618) 622-9225

Fax

(618) 624-6731

NPI assigned

Sep 14, 2005

Last updated

Aug 17, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 8

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Southern College of Optometry, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Avc Optometry IncGroup PAC ID 7214345735, 6 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

98.99 of 100Reported as group

Quality

97.98

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/15086/brand/1/csg/1/fhir/r4
• Direct secure messaging: keithhamm@direct.eyecare-partners.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Avc Optometry Inc

  dba Advanced Vision Care

  • Optometrist
  • Nashville, IL
  • NPI 1285214544
  Medicare reassignment Care Compare group NPD
• Clarkson Optometry Illinois, P.C.

  dba Clarkson Eyecare

  • Optometrist
  • Ballwin, MO
  • NPI 1548635758

  IL

  Medicare reassignment NPD
• Avc Optometry Inc

  • Optometrist
  • Columbia, IL
  • NPI 1982348587
  NPD
• Clarkson Optometry Illinois, P.C.

  dba Clarkson Eyecare

  • Optometrist
  • Centralia, IL
  • NPI 1730373648
  NPD
• Lynley E Atwood, LLC

  • Optometrist
  • Bethalto, IL
  • NPI 1134636491
  NPD (past)
• Mark a Ellison, LTD

  dba Family Vision Care of Southern Illinois

  • Optometrist
  • Bethalto, IL
  • NPI 1013967116
  NPD (past)
• Nu-Crown, LLC

  dba Crown Optical

  • Optometrist
  • Alton, IL
  • NPI 1295737294
  NPD (past)
• Taylorville Vision Center, LTD

  • Optometrist
  • Taylorville, IL
  • NPI 1669656252
  NPD (past)

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

{
    "created_epoch": "1126656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660694400000",
    "number": "1225023401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 E NORTH ST",
            "city": "EUREKA",
            "state": "MO",
            "postal_code": "630251205",
            "telephone_number": "636-200-4393",
            "fax_number": "636-938-2650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3248 GREEN MOUNT CROSSING DR",
            "city": "SHILOH",
            "state": "IL",
            "postal_code": "622697284",
            "telephone_number": "618-622-9225",
            "fax_number": "618-624-6731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMM",
        "first_name": "KEITH",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-14",
        "last_updated": "2022-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046-009444",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "20020153161",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046-009444",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "612276",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED",
            "identifier": "94444",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "166472",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00238170",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046-009444",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MED COMPLETE",
            "identifier": "30821",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHP",
            "identifier": "238288",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alfred O Greco, MD
• Alexander Charles Greff, PA-C
• Kristen Kapalka Griffin
• Michael G Guignon Jr., M.D.
• Lyman Lansing Hale IV, M.D., M.S.
• Deirdre Hart, MD
• Kristina Mae Heafner, D.C.
• Heartland Women's Healthcare Il PC
• Dana Michelle Heimann
• Anna Marie Herring, DNP FNP-C

• Optometrist in Shiloh, IL
• Providers in Shiloh, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.