NPIMap

Organization Active NPI

Hamilton Physician Group Inc

  • Cardiovascular Disease Physician
  • Dalton, GA
National Provider Identifier
1235455569
Registry record updated Jun 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
HAMILTON PHYSICIAN GROUP INC
Practice address
1107 Memorial Dr Ste 302
Dalton, GA 30720
Phone
(706) 529-6015
Fax
(706) 529-6017
NPI assigned
Apr 12, 2010
Last updated
Jun 14, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2018

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

Authorized official

Name
Sandy McKenzie
Title
Executive V.P./Coo
Phone
(706) 272-6289

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X Primary

Addresses

Primary practice location

1107 Memorial Dr Ste 302
Dalton, GA 30720

Mailing address

PO Box 1587
Dalton, GA 30722-1587
Phone (706) 529-7440

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, TN3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20041119001024 GA Part A Provider - Hospital 0446151179 2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Dalton, GA; Ringgold, GA; Chatsworth, GA
O20100831000467 GA Part B Supplier - Clinic/Group Practice 4789708553 Receives reassigned benefits from 182 practitioners
Practice locations: Ringgold, GA; Dalton, GA; Calhoun, GA; Chatsworth, GA
O20111021000088 TN Part B Supplier - Clinic/Group Practice 4789708553 Receives reassigned benefits from 11 practitioners
Practice locations: Chattanooga, TN; Cleveland, TN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1235455569. Details of each certification follow.

Hospital certification: CCN 110001

Legal name
HAMILTON MEDICAL CENTER, INC
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Apr 7, 2025
Beds
282
Ownership / control type
Private (not for profit)
Most recent change of ownership
Sep 30, 1996 (1 total)
Organization structure
CorporationNon-profit
Incorporated
Oct 26, 1982 in GA
Enrollment address
1200 Memorial Dr
Dalton, GA 30720-2529
Other Hospital Practice Location
Hospital subgroups
General, Acute care, Psychiatric unit

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
Hamilton Medical CenterCCN 110001 · All quality measures
Overall star rating
3 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
No

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D1024680Hamilton Physician Group1107 Memorial Drive, Suite 200, Dalton, GA 30720Certificate of waiverNov 12, 2026

National Provider Directory

National Provider Directory
Tax ID family
Emergency Physicians-Ha8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Locations (25 of 26)

111 Laurel Creek Rd SE
#B
Calhoun, GA 30701
Phone (706) 625-1574

160 Curtis Pkwy NE
Ste B
Calhoun, GA 30701
Phone (706) 529-3025

215 Curtis Pkwy NE
Calhoun, GA 30701
Phone (706) 226-3434

407 2nd Ave
Calhoun, GA 30701
Phone (706) 403-4613

1422 Green Rd
Ste D
Chatsworth, GA 30705
Phone (706) 277-7311

800 Gi Maddox Pkwy
Chatsworth, GA 30705
Phone (706) 686-8015

1107 Memorial Dr
Dalton, GA 30720
Phone (706) 217-6950

1107 Memorial Dr
#302
Dalton, GA 30720
Phone (706) 529-8710

1107 Memorial Dr
Ste 100
Dalton, GA 30720
Phone (706) 529-3072

1107 Memorial Dr
Ste 200
Dalton, GA 30720
Phone (706) 226-9355

1107 Memorial Dr
Ste 302
Dalton, GA 30720
Phone (706) 529-6015

1107 Memorial Dr
Ste G2
Dalton, GA 30720
Phone (706) 529-3245

1107 Memorial Dr
Ste G3
Dalton, GA 30720
Phone (706) 259-7072

1243 Broadrick Dr
Ste A
Dalton, GA 30720
Phone (706) 275-6121

1410 Chattanooga Ave
Dalton, GA 30720
Phone (706) 226-4623

1503 Professional Ct
Dalton, GA 30720
Phone (706) 281-2121

3957 Cleveland Hwy
Dalton, GA 30721
Phone (706) 529-3245

3957 Cleveland Hwy
#B
Dalton, GA 30721
Phone (706) 694-4600

475 Reed Rd
Ste 104
Dalton, GA 30720
Phone (706) 529-8710

45 College Park Dr
Ringgold, GA 30736
Phone (706) 965-4060

45 College Park Dr
Ste A
Ringgold, GA 30736
Phone (706) 529-7440

45 College Park Dr
Ste B
Ringgold, GA 30736
Phone (706) 529-3735

4635 Battlefield Pkwy
Ringgold, GA 30736
Phone (706) 259-3336

4645 Battlefield Pkwy
Ringgold, GA 30736
Phone (423) 648-2362

6031 Shallowford Rd
Ste 117
Chattanooga, TN 37421
Phone (423) 495-9581

Ownership & related parties

All disclosed owners & managing parties 7

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Robert Brooker Individual Corporate Director Nov 6, 2007
Hamilton Medical Center, Inc Organization, Dalton, GA Corporation, Non-profit 5% Or Greater Direct Ownership Interest Sep 30, 1996
Operational/Managerial Control Nov 6, 2007
Robert Hubbs Individual Corporate Director Nov 6, 2007
Robert Chandler Individual Corporate Director Nov 6, 2007
Randall Foster Individual Corporate Director Jun 13, 2019
W-2 Managing Employee May 12, 1986
Yvette Lee Individual W-2 Managing Employee Oct 3, 2016
Jonathan David Gregg Individual Corporate Director Jul 1, 2015

Owners & managing parties with NPI records 3

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 436

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 436

Affiliated clinicians 477

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 477

NPI Registry JSON

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

{
    "created_epoch": "1271030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1528934400000",
    "number": "1235455569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1587",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307221587",
            "telephone_number": "706-529-7440",
            "fax_number": "706-529-7437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1107 MEMORIAL DR STE 302",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "30720",
            "telephone_number": "706-529-6015",
            "fax_number": "706-529-6017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAMILTON PHYSICIAN GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-12",
        "last_updated": "2018-06-14",
        "status": "A",
        "authorized_official_last_name": "MCKENZIE",
        "authorized_official_first_name": "SANDY",
        "authorized_official_title_or_position": "EXECUTIVE V.P./COO",
        "authorized_official_telephone_number": "706-272-6289"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dalton, GA

Sources for this page

Verify at the official NPI Registry.