Individual provider Active NPI

Nicole Hamilton, FNP

  • Family Nurse Practitioner
  • Raytown, MO
National Provider Identifier
1417501255
Registry record updated Dec 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2019028906 Issued in MO
Practice address
8801 E 63Rd St Ste 102
Raytown, MO 64133-4865
Phone
(816) 255-0837
Fax
(816) 366-7855
NPI assigned
Jul 30, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2019028906 MO Primary

Addresses

Primary practice location

8801 E 63Rd St Ste 102
Raytown, MO 64133-4865

Mailing address

8801 E 63Rd St Ste 102
Raytown, MO 64133-4865
Phone (816) 255-0837

Other identifiers 1

IdentifierTypeStateIssuer
2019028906OtherMOSTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190930000536 MO Practitioner - Nurse Practitioner 5991034738

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

9140 E Hwy 350
Raytown, MO 64133-5719
Phone (816) 255-0837

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
NDH Medicare Risk Assessment LLC Family CurrentSince Oct 1, 2022 Accepting new patients

Locations

8801 E 63rd St
Ste 102
Raytown, MO 64133
Phone (816) 255-0837

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": "1564444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733270400000",
    "number": "1417501255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8801 E 63RD ST STE 102",
            "city": "RAYTOWN",
            "state": "MO",
            "postal_code": "641334865",
            "telephone_number": "816-255-0837",
            "fax_number": "816-366-7855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8801 E 63RD ST STE 102",
            "city": "RAYTOWN",
            "state": "MO",
            "postal_code": "641334865",
            "telephone_number": "816-255-0837",
            "fax_number": "816-366-7855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMILTON",
        "first_name": "NICOLE",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-30",
        "last_updated": "2024-12-04",
        "certification_date": "2024-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2019028906",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "2019028906",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Raytown, MO

Sources for this page

Verify at the official NPI Registry.