Active NPI
James R Hammond, PHD
- Clinical Psychologist
- Schaumburg, IL
National Provider Identifier
1376755397
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 071-004681
- Practice address
- 1325 Wiley Rd
Suite 165
Schaumburg, IL 60173-4383 - Phone
- (630) 674-7881
- Fax
- (847) 310-4690
- NPI assigned
- May 3, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 071-004681 | IL | Primary |
Addresses
Primary practice location
1325 Wiley Rd
Suite 165
Schaumburg, IL 60173-4383
Mailing address
3200 Sheridan Rd
Ste 104
Kenosha, WI 53140-1921
Phone (630) 674-7881
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 12007736 | Other | CAQH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090408000647 | WI | Practitioner - Clinical Psychologist | 5890860456 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1991
- Medicare assignment
- May accept Medicare assignment
- Group practices
- Thrive Therapy Services LLC
Practice addresses (Care Compare)
3200 Sheridan Rd
Suite 104
Kenosha, WI 53140-1921
Phone (262) 997-9411
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 071-004681 | IL | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thrive Therapy Services LLC | Current | Accepting new patients | |
| Davken Associates, P.C. | Clinical | Past | Accepting new patients |
Locations
3200 Sheridan Rd
Ste 104
Kenosha, WI 53140
Phone (262) 288-6216
Organizations & group practices 2
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178150400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1566345600000",
"number": "1376755397",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3200 SHERIDAN RD",
"address_2": "STE 104",
"city": "KENOSHA",
"state": "WI",
"postal_code": "531401921",
"telephone_number": "630-674-7881",
"fax_number": "847-310-4690"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1325 WILEY RD",
"address_2": "SUITE 165",
"city": "SCHAUMBURG",
"state": "IL",
"postal_code": "601734383",
"telephone_number": "630-674-7881",
"fax_number": "847-310-4690"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAMMOND",
"first_name": "JAMES",
"middle_name": "R",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-03",
"last_updated": "2019-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "IL",
"license": "071-004681",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAQH",
"identifier": "12007736",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Schaumburg, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2019; 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.