Individual provider Active NPI

Mary Hamer, M.D.

  • Diagnostic Radiology Physician
  • Lake City, FL
National Provider Identifier
1467484006
Registry record updated Jul 20, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
ME 87362 Issued in FL
Practice address
Vamc
Marion St.
Lake City, FL 32025
Phone
(386) 755-3016
NPI assigned
Jul 6, 2006
Last updated
Jul 20, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X ME 87362 FL Primary

Addresses

Primary practice location

Vamc
Marion St.
Lake City, FL 32025

Mailing address

826 SW Amberwood Loop Apt 106
Lake City, FL 32025-6980
Phone (386) 755-3016

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME 87362FLMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Montgomery Radiology Associates, PA PastSince Jul 1, 2012 Accepting new patients

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, 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": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184889600000",
    "number": "1467484006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "826 SW AMBERWOOD LOOP APT 106",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320256980",
            "telephone_number": "386-755-3016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "VAMC",
            "address_2": "MARION ST.",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "32025",
            "telephone_number": "386-755-3016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMER",
        "first_name": "MARY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-06",
        "last_updated": "2007-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "ME 87362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2007; 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.