Autumn Victoria Grace Hampton, MASTERS PSYCHOLOGY

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

648 Coral Trace Blvd
Edgewater, FL 32132-6942

Phone

(606) 259-6072

NPI assigned

Dec 3, 2020

Sex

Female

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 3, 2020.

{
    "created_epoch": "1606953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606953600000",
    "number": "1699370809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "648 CORAL TRACE BLVD",
            "city": "EDGEWATER",
            "state": "FL",
            "postal_code": "321326942",
            "telephone_number": "606-259-6072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "648 CORAL TRACE BLVD",
            "city": "EDGEWATER",
            "state": "FL",
            "postal_code": "321326942",
            "telephone_number": "606-259-6072"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "140 S Beach St Ste 416",
            "address_purpose": "LOCATION",
            "city": "Daytona Beach",
            "state": "FL",
            "postal_code": "321144472",
            "country_code": "US",
            "telephone_number": "386-747-6541",
            "fax_number": "866-401-6150",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAMPTON",
        "first_name": "AUTUMN",
        "middle_name": "VICTORIA GRACE",
        "name_prefix": "Miss",
        "credential": "MASTERS PSYCHOLOGY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-03",
        "last_updated": "2020-12-03",
        "certification_date": "2020-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christian Patrick Grause, DC
• Pamela Lynn Griffin
• Vicki L Gross, MT-BC
• Paula Adelle Hall, D.O.
• Angel Hampton, APRN
• Kristen Ann Hanak, P.T.
• Hands on Healing Massage Therapy
• Richard Michael Hartman, CRNA
• Tori Hartmann, FNP-C
• Charlotte Anna Harts

• All providers in Edgewater, FL
• Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2020; 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.