Active NPI
Mickra Hamilton King
- Audiologist
- Charleston, WV
National Provider Identifier
1437326295
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- A: 0221
- Practice address
- 1679 Coonskin Dr
130TH Medical Group
Charleston, WV 25311-1023 - Phone
- (304) 341-6252
- Fax
- (304) 341-6252
- NPI assigned
- May 12, 2008
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Audiologist | 231H00000X | A: 0221 | WV | Primary |
Addresses
Primary practice location
1679 Coonskin Dr
130TH Medical Group
Charleston, WV 25311-1023
Mailing address
1679 Coonskin Dr
130TH Medical Group
Charleston, WV 25311-1023
Other names 1
- Mickra Kay Hamilton
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A: 0221 | WV | MD | Audiologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1210550400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1210550400000",
"number": "1437326295",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1679 COONSKIN DR",
"address_2": "130TH MEDICAL GROUP",
"city": "CHARLESTON",
"state": "WV",
"postal_code": "253111023",
"fax_number": "304-341-6252"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1679 COONSKIN DR",
"address_2": "130TH MEDICAL GROUP",
"city": "CHARLESTON",
"state": "WV",
"postal_code": "253111023",
"telephone_number": "304-341-6252",
"fax_number": "304-341-6252"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KING",
"first_name": "MICKRA",
"middle_name": "HAMILTON",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-05-12",
"last_updated": "2008-05-12",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "WV",
"license": "A: 0221",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MICKRA",
"last_name": "HAMILTON",
"middle_name": "KAY",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Charleston, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.