Individual provider Active NPI

Justin Alexander Hamilton, M.D.

  • Emergency Medicine Physician
  • Fort Campbell, KY
National Provider Identifier
1376862516
Registry record updated Nov 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
50374 Issued in TN
Practice address
650 Joel Dr
Fort Campbell, KY 42223-5318
Phone
(270) 798-8500
NPI assigned
May 27, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 50374 TN Primary

Addresses

Primary practice location

650 Joel Dr
Fort Campbell, KY 42223-5318

Mailing address

2020 21St Ave S Ste 201
Nashville, TN 37212-4354
Phone (615) 269-0652

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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

Enrollment IDStateProvider typePAC IDDetails
I20131003000320 TN Practitioner - Emergency Medicine 9638303753 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Indiana University School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Middle Tennessee Emergency Physicians, P.C.Group PAC ID 3678464526, 85 clinicians

Practice addresses (Care Compare)

520 W Main St
Smithville, TN 37166-1138
Phone (615) 215-5000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
50374TNMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Emergency Physicians LLC Emergency Medicine CurrentSince Mar 1, 2023 Accepting new patients
Middle Tennessee Emergency Physicians PC Emergency Medicine CurrentSince Jun 1, 2022 Accepting new patients
App of Tennessee Ed, PLLC Emergency Medicine CurrentSince Jul 20, 2015 Accepting new patients
Emergency Physicians of Montgomery County, PLLC Emergency Medicine Past Accepting new patients

Locations

1643 NW 136th Ave
Ste 100
Sunrise, FL 33323
Phone (865) 500-1325

320 W 18th St
Hopkinsville, KY 42240
Phone (270) 887-0100

1 Medical Park Blvd
Ste 210E
Bristol, TN 37620
Phone (423) 224-4000

651 Dunlop Ln
Clarksville, TN 37040
Phone (931) 502-1000

130 W Ravine Rd
Kingsport, TN 37660
Phone (423) 224-3150

9352 Park West Blvd
Knoxville, TN 37923
Phone (865) 373-1000

907 Lamar Alexander Pkwy
Maryville, TN 37804
Phone (865) 766-8818

2000 Church St
Nashville, TN 37236
Phone (615) 284-4672

520 W Main St
Smithville, TN 37166
Phone (615) 215-5000

1519 Main St
Sneedville, TN 37869
Phone (423) 733-5000

401 Sewell Dr
Sparta, TN 38583
Phone (931) 738-2164

Organizations & group practices 4

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1274918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669766400000",
    "number": "1376862516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 21ST AVE S STE 201",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372124354",
            "telephone_number": "615-269-0652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 JOEL DR",
            "city": "FORT CAMPBELL",
            "state": "KY",
            "postal_code": "422235318",
            "telephone_number": "270-798-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMILTON",
        "first_name": "JUSTIN",
        "middle_name": "ALEXANDER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-27",
        "last_updated": "2022-11-30",
        "certification_date": "2022-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "50374",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Campbell, KY

Sources for this page

Verify at the official NPI Registry.