Derrick Jack Hamilton, D.O.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

02998 Issued in KY

Practice address

1484 Lakeside Drive
Jackson, KY 41339-6555

Phone

(606) 666-9950

Fax

(606) 666-9136

NPI assigned

Oct 10, 2006

Last updated

Mar 13, 2020By 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 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in KY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Internal Medicine

Education

University of Pikeville, Kentucky College of Osteopathic Med, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Juniper Health IncGroup PAC ID 2961453618, 22 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Kentucky River Medical Center Hospital, Jackson, KY, CCN 181334

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: derrick.hamilton.p1@direct.juniperhealth.nextgenshare.com
• Direct secure messaging: derrickhamilton@juniperhea.allscriptsdirect.net
• Direct secure messaging: dhamil01@yourcarecommunity.org

All facility ownership & control disclosures 17

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 18

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Juniper Health Inc

  dba Juniper Health Rogers Elementary School

  • Federally Qualified Health Center (FQHC)
  • Rogers, KY
  • NPI 1114705944

  Corporate Officer, W-2 Managing Employee

  CMS ownership
• Juniper Health Inc

  dba Juniper Health Breathitt Elementary

  • Federally Qualified Health Center (FQHC)
  • Jackson, KY
  • NPI 1124807177

  Corporate Officer, W-2 Managing Employee

  CMS ownership
• Juniper Health Inc

  dba Juniper Health Breathitt High School

  • Federally Qualified Health Center (FQHC)
  • Jackson, KY
  • NPI 1164201117

  Corporate Officer, W-2 Managing Employee

  CMS ownership
• Juniper Health Inc

  dba Lee County Family Medical Clinic

  • Federally Qualified Health Center (FQHC)
  • Beattyville, KY
  • NPI 1407818628

  Corporate Officer, W-2 Managing Employee

  CMS ownership
• Juniper Health Inc

  dba Juniper Health Menifee County

  • Federally Qualified Health Center (FQHC)
  • Frenchburg, KY
  • NPI 1447037122

  Corporate Officer, W-2 Managing Employee

  CMS ownership
• Juniper Health Inc

  dba Juniper Morgan County

  • Federally Qualified Health Center (FQHC)
  • West Liberty, KY
  • NPI 1447791512

  Corporate Officer, W-2 Managing Employee

  CMS ownership
• Juniper Health Inc

  dba Breathitt County Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Jackson, KY
  • NPI 1467417691

  Corporate Officer, W-2 Managing Employee

  CMS ownership
• Juniper Health Inc

  dba Juniper Health Sebastian Elementary School

  • Federally Qualified Health Center (FQHC)
  • Jackson, KY
  • NPI 1528847670

  Corporate Officer, W-2 Managing Employee

  CMS ownership
• Juniper Health Inc

  dba Juniper Health Red River Elementary School

  • Federally Qualified Health Center (FQHC)
  • Hazel Green, KY
  • NPI 1609654276

  Corporate Officer, W-2 Managing Employee

  CMS ownership
• Juniper Health Inc

  dba Juniper Health Wolfe County Middle School

  • Federally Qualified Health Center (FQHC)
  • Campton, KY
  • NPI 1619755287

  Corporate Officer, W-2 Managing Employee

  CMS ownership
• Juniper Health Inc

  dba Juniper Health Elliott County

  • Federally Qualified Health Center (FQHC)
  • Sandy Hook, KY
  • NPI 1669014627

  Corporate Officer, W-2 Managing Employee

  CMS ownership
• Juniper Health Inc

  dba Lee County Family Medical Clinic

  • Federally Qualified Health Center (FQHC)
  • Beattyville, KY
  • NPI 1669588505

  Corporate Officer, W-2 Managing Employee

  CMS ownership

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.

• Juniper Health Inc

  dba Lee County Family Medical Clinic

  • Federally Qualified Health Center (FQHC)
  • Beattyville, KY
  • NPI 1407818628
  Medicare reassignment Care Compare group NPD Authorized official
• Juniper Health Inc

  dba Juniper Morgan County

  • Federally Qualified Health Center (FQHC)
  • West Liberty, KY
  • NPI 1447791512
  NPD Authorized official
• Juniper Health Inc

  dba Juniper Health Rogers Elementary School

  • Federally Qualified Health Center (FQHC)
  • Rogers, KY
  • NPI 1114705944
  Authorized official Same address or phone
• Juniper Health Inc

  dba Juniper Health Breathitt Elementary

  • Federally Qualified Health Center (FQHC)
  • Jackson, KY
  • NPI 1124807177
  Authorized official Same address or phone
• Juniper Health Inc

  dba Juniper Health Breathitt High School

  • Federally Qualified Health Center (FQHC)
  • Jackson, KY
  • NPI 1164201117
  Authorized official Same address or phone
• Juniper Health Inc

  dba Juniper Health Menifee County

  • Federally Qualified Health Center (FQHC)
  • Frenchburg, KY
  • NPI 1447037122
  Authorized official Same address or phone
• Juniper Health Inc

  dba Breathitt County Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Jackson, KY
  • NPI 1467417691
  NPD (past) Authorized official
• Juniper Health Inc

  dba Juniper Health Sebastian Elementary School

  • Federally Qualified Health Center (FQHC)
  • Jackson, KY
  • NPI 1528847670
  Authorized official Same address or phone
• Juniper Health Inc

  dba Juniper Health Red River Elementary School

  • Federally Qualified Health Center (FQHC)
  • Hazel Green, KY
  • NPI 1609654276
  Authorized official Same address or phone
• Juniper Health Inc

  dba Juniper Health Wolfe County Middle School

  • Federally Qualified Health Center (FQHC)
  • Campton, KY
  • NPI 1619755287
  Authorized official Same address or phone
• Juniper Health Inc

  dba Juniper Health Elliott County

  • Federally Qualified Health Center (FQHC)
  • Sandy Hook, KY
  • NPI 1669014627
  Authorized official Same address or phone
• Juniper Health Inc

  dba Lee County Family Medical Clinic

  • Federally Qualified Health Center (FQHC)
  • Beattyville, KY
  • NPI 1669588505
  Authorized official Same address or phone

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Jackson Hospital Corporation

  dba Kentucky River Medical Center

  • Critical Access Hospital
  • Jackson, KY
  • NPI 1346247962
  Care Compare affiliation

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584057600000",
    "number": "1376631283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 690",
            "city": "BEATTYVILLE",
            "state": "KY",
            "postal_code": "413110690",
            "telephone_number": "606-464-0151",
            "fax_number": "606-464-0152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1484 LAKESIDE DRIVE",
            "city": "JACKSON",
            "state": "KY",
            "postal_code": "413396555",
            "telephone_number": "606-666-9950",
            "fax_number": "606-666-9136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMILTON",
        "first_name": "DERRICK",
        "middle_name": "JACK",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2020-03-13",
        "certification_date": "2020-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "02998",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICIAID FQHC GROUP WOLFE",
            "identifier": "1962823393",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100015160",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID FQHC GROUP JACKSON",
            "identifier": "1467417691",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICIAID FQHC GROUP LEE",
            "identifier": "1407818628",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rodney Brian Griffith, D.M.D.
• Carl Gross
• Kelli Gross
• Barbara Ella Hagans
• Eric Bradley Hall
• Venitia Hardin
• Donna Hawse
• Chelsea Hays, APRN-BC
• Kevin R Hayton
• Billy Jordan Helton, PTA

• Internal Medicine Physician in Jackson, KY
• Providers in Jackson, KY by specialty
• Internal Medicine Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; 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.