Individual provider Active NPI

Derrick Hamilton, DC

  • Chiropractor
  • Belleville, IL
National Provider Identifier
1629476452
Registry record updated May 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038.012677 Issued in IL
Practice address
140 Iowa Ave Ste 7
Belleville, IL 62220-3940
Phone
(618) 416-1123
Fax
(217) 803-2485
NPI assigned
Dec 10, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 31, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038.012677 IL Primary

Addresses

Primary practice location

140 Iowa Ave Ste 7
Belleville, IL 62220-3940

Mailing address

140 Iowa Ave
Belleville, IL 62220-3940
Phone (618) 416-1123

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

State licenses

LicenseStateTypeSpecialty
038.012677ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
We Adjust That Chiropractic Centers LLC Chiropractor CurrentSince Jun 5, 2022 Accepting new patients

Locations

140 Iowa Ave
Ste 7
Belleville, IL 62220
Phone (618) 416-1123

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1418169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653955200000",
    "number": "1629476452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 IOWA AVE",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622203940",
            "telephone_number": "618-416-1123",
            "fax_number": "217-803-2485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 IOWA AVE STE 7",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622203940",
            "telephone_number": "618-416-1123",
            "fax_number": "217-803-2485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMILTON",
        "first_name": "DERRICK",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-12-10",
        "last_updated": "2022-05-31",
        "certification_date": "2022-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038.012677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Belleville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 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.