Organization Active NPI

Colin Hamblin, a Professional Medical Corporation

  • Family Medicine Physician
  • Point Reyes Station, CA
National Provider Identifier
1649664087
Registry record updated Jul 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
COLIN HAMBLIN, A PROFESSIONAL MEDICAL CORPORATION
Practice address
11150 Highway 1
Point Reyes Station, CA 94956
Phone
(415) 663-1082
Fax
(415) 663-9474
NPI assigned
Mar 24, 2015
Last updated
Jul 18, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2018

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

Authorized official

Name
Dr. Basil Colin Hamblin, M.D.NPI 1114095106
Title
President
Phone
(415) 663-1082

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

11150 Highway 1
Point Reyes Station, CA 94956

Mailing address

PO Box 240
11150 State Route 1
Point Reyes Station, CA 94956-0240
Phone (415) 663-1082

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151009000816 CA Part B Supplier - Clinic/Group Practice 3678881737 Receives reassigned benefits from 3 practitioners
Practice locations: Point Reyes Station, CA

National Provider Directory

National Provider Directory

Interoperability endpoints

  • Direct secure messaging: basilhamblin@chapmc.allscriptsdirect.net
  • Direct secure messaging: lydiaschindler@chapmc.allscriptsdirect.net
  • Direct secure messaging: meganlandeck@chapmc.allscriptsdirect.net

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1427155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531872000000",
    "number": "1649664087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 240",
            "address_2": "11150 STATE ROUTE 1",
            "city": "POINT REYES STATION",
            "state": "CA",
            "postal_code": "949560240",
            "telephone_number": "415-663-1082",
            "fax_number": "415-663-9474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11150 HIGHWAY 1",
            "city": "POINT REYES STATION",
            "state": "CA",
            "postal_code": "94956",
            "telephone_number": "415-663-1082",
            "fax_number": "415-663-9474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLIN HAMBLIN, A PROFESSIONAL MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-24",
        "last_updated": "2018-07-18",
        "status": "A",
        "authorized_official_last_name": "HAMBLIN",
        "authorized_official_first_name": "BASIL",
        "authorized_official_middle_name": "COLIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "415-663-1082",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Point Reyes Station, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.