Miranda Grace Hamelberg, PSYCHOLOGIST

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

0810005797 Issued in VA

Practice address

2005 Knight Lane
BLDG H Navy Medicine Support Command
Jacksonville, FL 32212

Phone

(904) 542-7200

NPI assigned

Oct 23, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• United States Navy

  • Military Hospital
  • Jacksonville, FL
  • NPI 1427328319
  NPD (past)

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

{
    "created_epoch": "1445558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510617600000",
    "number": "1427420942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3850 WEATHERSTONE CIR",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325071422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2005 KNIGHT LANE",
            "address_2": "BLDG H NAVY MEDICINE SUPPORT COMMAND",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32212",
            "telephone_number": "904-542-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMELBERG",
        "first_name": "MIRANDA",
        "middle_name": "GRACE",
        "name_prefix": "Dr.",
        "credential": "PSYCHOLOGIST",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-10-23",
        "last_updated": "2017-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810005797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Faith Danielle Hamamura, MD
• Anthony Edward Hamaty, MD
• Mireille Hamdan, RDN
• Irram Hamdani, M.D
• Ajmal Hameed, M.D.
• Erin Rae Spadaro Hamersley, D.O.
• Jessica Hames
• Tewabech K Hamesso
• Blake Hamil
• Amah Olufumilayo Hamilton

• Clinical Psychologist in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Clinical Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.