Individual provider Active NPI

Jason Hamrick

  • Psychiatric/Mental Health Nurse Practitioner
  • Chattanooga, TN
National Provider Identifier
1669095907
Registry record updated Jan 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
28256 Issued in TN
Practice address
6110 Shallowford Rd
Chattanooga, TN 37421-1894
Phone
(423) 618-6442
NPI assigned
May 21, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 14, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN9488515 FL
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 11008981 FL
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 28256 TN Primary

Addresses

Primary practice location

6110 Shallowford Rd
Chattanooga, TN 37421-1894

Mailing address

6110 Shallowford Rd Ste B
Chattanooga, TN 37421-1894

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210429001389 TN Practitioner - Nurse Practitioner 2567871700 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Vanderbilt University School of Medicine, 2020
Medicare assignment
May accept Medicare assignment
Group practices
Dowell Springs Behavioral Health, LLCGroup PAC ID 5597157016, 11 clinicians

Practice addresses (Care Compare)

1444 Old Weisgarber Rd
Knoxville, TN 37909-1293
Phone (865) 722-7780

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN9488515FLMDRegistered Nurse
11008981FLMDPsychiatric/Mental Health Nurse Practitioner
28256TNMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dowell Springs Behavioral Health, LLC CurrentSince Sep 18, 2023 Accepting new patients

Locations

6100 Tower Cir
Ste 1000
Franklin, TN 37067
Phone (615) 454-7459

1444 Old Weisgarber Rd
Knoxville, TN 37909
Phone (865) 500-6665

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": "1590019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642118400000",
    "number": "1669095907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6110 SHALLOWFORD RD STE B",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374211894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6110 SHALLOWFORD RD",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374211894",
            "telephone_number": "423-618-6442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMRICK",
        "first_name": "JASON",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-05-21",
        "last_updated": "2022-01-14",
        "certification_date": "2022-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "RN9488515",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "11008981",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TN",
            "license": "28256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

Verify at the official NPI Registry.