Individual provider Active NPI

Walter Vincent Hamilton III, MSN;CRNA

  • Certified Registered Nurse Anesthetist
  • Adrian, MI
National Provider Identifier
1669412615
Registry record updated Mar 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704222557 Issued in MI
Practice address
818 Riverside Ave
Adrian, MI 49221-1446
Phone
(517) 265-0900
NPI assigned
Jun 7, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 14, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 4704222557 MI Primary

Addresses

Primary practice location

818 Riverside Ave
Adrian, MI 49221-1446

Mailing address

5795 Stoney Brook Rd
Kalamazoo, MI 49009-7700
Phone (269) 217-4781

Other identifiers 1

IdentifierTypeStateIssuer
0N37190OtherMIGRP BCBS NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, IN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20120815000407 OH Practitioner - Certified Registered Nurse Anesthetist (Crna) 8224040993 Reassigns benefits to 2 organizations
I20130121000012 IN Practitioner - Certified Registered Nurse Anesthetist (Crna) 8224040993 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Porter County Anesthesia Associates PCGroup PAC ID 4789573411, 29 clinicians

Practice addresses (Care Compare)

85 E US Hwy 6
Valparaiso, IN 46383-8947
Phone (219) 983-5743

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Services of Greater Dayton, LLC Nurse Anesthetist, Certified Registered CurrentSince Mar 15, 2021 Accepting new patients
Anesthesia Dynamics LLC Nurse Anesthetist, Certified Registered CurrentSince Nov 1, 2021 Accepting new patients
Porter County Anesthesia Associates PC CurrentSince Aug 1, 2021 Accepting new patients
Ams Northern Indiana LLC Nurse Anesthetist, Certified Registered CurrentSince Sep 1, 2021 Accepting new patients
Ohio Anesthesia Group, Inc Nurse Anesthetist, Certified Registered CurrentSince Apr 22, 2021 Accepting new patients
Digestive Care of Evansville PC Past Accepting new patients
Sunset Coast Anesthesia Associates PC Nurse Anesthetist, Certified Registered PastSince Jan 22, 2012 Accepting new patients
Northstar Anesthesia of Michigan II PC Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

9301 Connecticut Dr
Crown Point, IN 46307
Phone (219) 756-2100

4411 Washington Ave
Ste 100
Evansville, IN 47714
Phone (313) 637-9861

801 Saint Marys Dr
Ste 205W
Evansville, IN 47714
Phone (812) 477-6103

647 2nd St
Ste A
Jasper, IN 47546
Phone (812) 477-6103

1915 Lake Ave
Plymouth, IN 46563
Phone (219) 936-3181

53830 Generations Dr
South Bend, IN 46635
Phone (574) 217-0174

85 E US Highway 6
Valparaiso, IN 46383
Phone (219) 983-5743

1320 Timken Mercy Dr NW
Canton, OH 44708
Phone (330) 489-1000

4235 Indian Ripple Rd
Dayton, OH 45440
Phone (513) 217-2094

81 Sylvania Dr
Dayton, OH 45440
Phone (937) 431-9531

4235 Indian Ripple Rd
Ste 110
Dayton, OH 45440
Phone (937) 427-7800

1167 Independence Ave
Marion, OH 43302
Phone (614) 352-6479

Organizations & group practices 8

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363219200000",
    "number": "1669412615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5795 STONEY BROOK RD",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490097700",
            "telephone_number": "269-217-4781",
            "fax_number": "269-327-3168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "818 RIVERSIDE AVE",
            "city": "ADRIAN",
            "state": "MI",
            "postal_code": "492211446",
            "telephone_number": "517-265-0900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMILTON",
        "first_name": "WALTER",
        "middle_name": "VINCENT",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "MSN;CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2013-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704222557",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GRP BCBS NUMBER",
            "identifier": "0N37190",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Adrian, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.