Rebecca Jane Hamilton, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

APN0000007612 Issued in TN

Practice address

2204 Pavilion Dr
Suite 108
Kingsport, TN 37660-4657

Phone

(423) 392-6100

Fax

(423) 392-6159

NPI assigned

Sep 21, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sullivandigestivecenter@directaddress.net

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.

• Endoscopy Center of Kingsport

  • Endoscopy Clinic/Center
  • Kingsport, TN
  • NPI 1235140385
  NPD

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

{
    "created_epoch": "1127260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656547200000",
    "number": "1245226737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2204 PAVILION DR",
            "address_2": "SUITE 108",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376604657",
            "telephone_number": "423-392-6100",
            "fax_number": "423-392-6159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2204 PAVILION DR",
            "address_2": "SUITE 108",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376604657",
            "telephone_number": "423-392-6100",
            "fax_number": "423-392-6159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMILTON",
        "first_name": "REBECCA",
        "middle_name": "JANE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-21",
        "last_updated": "2022-06-30",
        "certification_date": "2022-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "APN0000007612",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1524413",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE RIVER V",
            "identifier": "TN0117",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS TENNESSEE",
            "identifier": "4306925",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010018404",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sullivandigestivecenter@directaddress.net",
            "affiliation": "Y",
            "endpointDescription": "Direct Message",
            "affiliationName": "Endoscopy Center of Kingsport",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2204 Pavilion Dr",
            "address_2": "Suite 108",
            "city": "Kingsport",
            "state": "TN",
            "country_code": "US",
            "postal_code": "376604657",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Pamela Faye Hallett, REGISTERED NURSE RNC
• Halliburton Orthodontics,P.C.
• Emily W Ham, CDE
• Rachel E. Hamelryck, M.S., CF-SLP
• Melissa C Hamilton, APRN
• William David Hamilton, DC
• Rebecca Leigh Michel Hamm
• Anthony Warren Hammonds, PHARM D
• Daniel K. Hammonds, CRNA
• Hanger Prosthetics & Orthotics Inc

• Nurse Practitioner in Kingsport, TN
• Providers in Kingsport, TN by specialty
• Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.