Keith Allen Hamilton

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

9620 Careys Run Pond Creek Rd
MC Dermott, OH 45652-3902

Phone

(740) 858-6683

NPI assigned

Jul 6, 2023

Sex

Male

Sole proprietor

Yes

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.

• Moving Forward Residential LLC

  • Community/Behavioral Health Agency
  • MC Dermott, OH
  • NPI 1811767684
  NPD
• Moving Forward Residential LLC

  • Community/Behavioral Health Agency
  • MC Dermott, OH
  • NPI 1871016691
  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 7, 2023.

{
    "created_epoch": "1688601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701907200000",
    "number": "1497433965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 402",
            "city": "WHEELERSBURG",
            "state": "OH",
            "postal_code": "456940402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9620 CAREYS RUN POND CREEK RD",
            "city": "MC DERMOTT",
            "state": "OH",
            "postal_code": "456523902",
            "telephone_number": "740-858-6683"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7175 State Route 104",
            "address_purpose": "LOCATION",
            "city": "Mc Dermott",
            "state": "OH",
            "postal_code": "456528899",
            "country_code": "US",
            "telephone_number": "740-858-6683",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAMILTON",
        "first_name": "KEITH",
        "middle_name": "ALLEN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-07-06",
        "last_updated": "2023-12-07",
        "certification_date": "2023-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Fyffe
• William H Goodson
• Beth Groves, L.P.N.
• Delores Hall, STNA
• Nicholas L Hall, LCDC II
• Jessica Hamm, CDCA
• Goble Oneal Hammonds
• Jeremy Hanson, CDCA
• James Harding
• Jessica Rose Hoffer

• All providers in MC Dermott, OH
• Case Manager/Care Coordinator in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2023; 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.