Individual provider Active NPI

Donald Ray Hamilton, MD

  • Developmental - Behavioral Pediatrics Physician
  • Tulsa, OK
National Provider Identifier
1285607663
Registry record updated Sep 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental - Behavioral Pediatrics PhysicianTaxonomy code 2080P0006X
License
13868 Issued in OK
Practice address
5110 S Yale Ave
Suite 103
Tulsa, OK 74135-7401
Phone
(918) 933-4005
Fax
(918) 933-6005
NPI assigned
Feb 8, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 20, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 13868 OK
Developmental - Behavioral Pediatrics Physician 2080P0006X 13868 OK Primary

Addresses

Primary practice location

5110 S Yale Ave
Suite 103
Tulsa, OK 74135-7401

Mailing address

5110 S Yale Ave
Suite 103
Tulsa, OK 74135-7401
Phone (918) 933-4005

Other identifiers 1

IdentifierTypeStateIssuer
100112700CMedicaidOK

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
13868OKMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1139356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474329600000",
    "number": "1285607663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5110 S YALE AVE",
            "address_2": "SUITE 103",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741357401",
            "telephone_number": "918-933-4005",
            "fax_number": "918-933-6005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5110 S YALE AVE",
            "address_2": "SUITE 103",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741357401",
            "telephone_number": "918-933-4005",
            "fax_number": "918-933-6005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMILTON",
        "first_name": "DONALD",
        "middle_name": "RAY",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-08",
        "last_updated": "2016-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OK",
            "license": "13868",
            "primary": false
        },
        {
            "code": "2080P0006X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": "OK",
            "license": "13868",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100112700C",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2016; 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.