Individual provider Active NPI

Brenda Lee Hamilton

  • Case Manager/Care Coordinator
  • Lisbon, OH
National Provider Identifier
1689437253
Registry record updated Sep 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
License
CDCA.188837 Issued in OH
Practice address
964 N Market St
Lisbon, OH 44432-9363
Phone
(330) 424-1468
Fax
(330) 424-7876
NPI assigned
Feb 5, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Peer Specialist 175T00000X
Case Manager/Care Coordinator 171M00000X CDCA.188837 OH Primary

Addresses

Primary practice location

964 N Market St
Lisbon, OH 44432-9363

Mailing address

PO Box 464
Lisbon, OH 44432-0464
Phone (330) 424-1468

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
CDCA.188837OHMDCase Manager/Care Coordinator

Practice roles

OrganizationSpecialtyStatusNew patients
Family Recovery Center CurrentSince Feb 11, 2024 Accepting new patients
Family Recovery Center CurrentSince Feb 11, 2024 Accepting new patients

Locations

964 N Market St
Lisbon, OH 44432
Phone (330) 424-1468

Organizations & group practices 2

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": "1707091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725408000000",
    "number": "1689437253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 464",
            "city": "LISBON",
            "state": "OH",
            "postal_code": "444320464",
            "telephone_number": "330-424-1468",
            "fax_number": "330-424-7876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "964 N MARKET ST",
            "city": "LISBON",
            "state": "OH",
            "postal_code": "444329363",
            "telephone_number": "330-424-1468",
            "fax_number": "330-424-7876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMILTON",
        "first_name": "BRENDA",
        "middle_name": "LEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-05",
        "last_updated": "2024-09-04",
        "certification_date": "2024-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "OH",
            "license": "CDCA.188837",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lisbon, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2024; 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.