Individual provider Active NPI

Hailey Raine Hamaker, L.E.

  • Specialist
  • Pacific Grove, CA
National Provider Identifier
1649601709
Registry record updated Jun 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
9767 Issued in CA
Practice address
222 17TH St
Pacific Grove, CA 93950-3325
Phone
(831) 241-4180
NPI assigned
Nov 27, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X
Specialist 174400000X 9767 CA Primary

Addresses

Primary practice location

222 17TH St
Pacific Grove, CA 93950-3325

Mailing address

222 17TH St
Pacific Grove, CA 93950-3325
Phone (831) 241-4180

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

LicenseStateTypeSpecialty
9767CAMDCritical Care Neonatal Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Terra Alchemia LLC Specialist CurrentSince Aug 6, 2023 Accepting new patients

Locations

222 17th St
Pacific Grove, CA 93950
Phone (831) 241-4180

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": "1385510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687996800000",
    "number": "1649601709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 17TH ST",
            "city": "PACIFIC GROVE",
            "state": "CA",
            "postal_code": "939503325",
            "telephone_number": "831-241-4180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 17TH ST",
            "city": "PACIFIC GROVE",
            "state": "CA",
            "postal_code": "939503325",
            "telephone_number": "831-241-4180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMAKER",
        "first_name": "HAILEY",
        "middle_name": "RAINE",
        "credential": "L.E.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-27",
        "last_updated": "2023-06-29",
        "certification_date": "2023-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "9767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pacific Grove, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 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.