Individual provider Active NPI

Kenneth Lorne Hamilton, D.C.

  • Chiropractor
  • Saint Clair Shores, MI
National Provider Identifier
1386793677
Registry record updated Mar 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301004816 Issued in MI
Practice address
27889 Harper Ave
Saint Clair Shores, MI 48081-1542
Phone
(586) 774-7171
Fax
(586) 774-6253
NPI assigned
Jan 9, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 10, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2301004816 MI Primary

Addresses

Primary practice location

27889 Harper Ave
Saint Clair Shores, MI 48081-1542

Mailing address

22546 Ardmore Park Dr
Saint Clair Shores, MI 48081-2011
Phone (586) 773-6762

Other identifiers 1

IdentifierTypeStateIssuer
1628250MedicaidMI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081010000258 MI Practitioner - Chiropractic 6800964370 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Harper Chiropractic Center P CGroup PAC ID 2264500735, 2 clinicians

Practice addresses (Care Compare)

27889 Harper Ave
Saint Clair Shores, MI 48081-1542
Phone (586) 774-7171

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2301004816MIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Harper Chiropractic Center P C Chiropractor CurrentSince Aug 6, 1983 Accepting new patients

Locations

27889 Harper Ave
St Clr Shores, MI 48081
Phone (586) 774-7171

Organizations & group practices 1

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": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205107200000",
    "number": "1386793677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22546 ARDMORE PARK DR",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480812011",
            "telephone_number": "586-773-6762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27889 HARPER AVE",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480811542",
            "telephone_number": "586-774-7171",
            "fax_number": "586-774-6253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMILTON",
        "first_name": "KENNETH",
        "middle_name": "LORNE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-09",
        "last_updated": "2008-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301004816",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1628250",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Clair Shores, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.