Individual provider Active NPI

Carol Hammerbeck

  • Psychiatry Physician
  • Jeffersonville, IN
National Provider Identifier
1457356487
Registry record updated Sep 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
26737 Issued in KY
Practice address
2780 Jefferson Centre Way Unit 104
Jeffersonville, IN 47130-8293
Phone
(812) 288-8622
Fax
(812) 288-8632
NPI assigned
Jun 16, 2005
Last updated
Sep 15, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 15, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 26737 KY Primary
Psychiatry Physician 2084P0800X 01059001A IN

Addresses

Primary practice location

2780 Jefferson Centre Way Unit 104
Jeffersonville, IN 47130-8293

Mailing address

2780 Jefferson Centre Way Unit 104
Jeffersonville, IN 47130-8293
Phone (812) 288-8622

Other identifiers 1

IdentifierTypeStateIssuer
200331410MedicaidIN

Other names 1

  • Dr. Carol M Hammerbeck Other name

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01059001AINMDPsychiatry Physician
26737KYMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Brightview LLC Past Accepting new patients
Hammerbeck Psychiatric Associates, LLC PastSince Jan 22, 2007 Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663200000000",
    "number": "1457356487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2780 JEFFERSON CENTRE WAY UNIT 104",
            "city": "JEFFERSONVILLE",
            "state": "IN",
            "postal_code": "471308293",
            "telephone_number": "812-288-8622",
            "fax_number": "812-288-8632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2780 JEFFERSON CENTRE WAY UNIT 104",
            "city": "JEFFERSONVILLE",
            "state": "IN",
            "postal_code": "471308293",
            "telephone_number": "812-288-8622",
            "fax_number": "812-288-8632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMMERBECK",
        "first_name": "CAROL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-06-16",
        "last_updated": "2022-09-15",
        "certification_date": "2022-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "KY",
            "license": "26737",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IN",
            "license": "01059001A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200331410",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAROL",
            "last_name": "HAMMERBECK",
            "middle_name": "M",
            "prefix": "DR.",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Jeffersonville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2022; 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.