NPIMap

Organization Active NPI

John Robert Hamill, Jr. M.D.P.a.

Doing business as Gulf Coast Dermatology

  • Specialist
  • Hudson, FL
National Provider Identifier
1720173032
Registry record updated May 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
ME0040078 Issued in FL
Legal business name
JOHN ROBERT HAMILL, JR. M.D.P.A.
Doing business as
Gulf Coast Dermatology
Practice address
7547 Jacque Rd
Hudson, FL 34667
Phone
(727) 862-8561
Fax
(727) 861-1951
NPI assigned
Oct 3, 2006
Last updated
May 23, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 23, 2012

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

Authorized official

Name
Dr. John Robert Hamill Jr., M.D.NPI 1114905312
Title
President
Phone
(727) 862-8561

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
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X ME0040078 FL Primary

Addresses

Primary practice location

7547 Jacque Rd
Hudson, FL 34667

Mailing address

7547 Jacque Rd
Hudson, FL 34667
Phone (727) 862-8561

Other names 1

  • Gulf Coast Dermatology Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040427001408 FL Part B Supplier - Clinic/Group Practice 9234126749 Receives reassigned benefits from 6 practitioners
Practice locations: Hudson, FL

National Provider Directory

National Provider Directory

Locations

12029 Cortez Blvd
Brooksville, FL 34613
Phone (352) 596-4090

7547 Jacque Rd
Hudson, FL 34667
Phone (727) 862-8561

34918 US 19 N
Palm Harbor, FL 34684
Phone (727) 772-7360

Practitioners & affiliated clinicians

Practitioners 17

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.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337731200000",
    "number": "1720173032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7547 JACQUE RD",
            "city": "HUDSON",
            "state": "FL",
            "postal_code": "34667",
            "telephone_number": "727-862-8561",
            "fax_number": "727-861-1951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7547 JACQUE RD",
            "city": "HUDSON",
            "state": "FL",
            "postal_code": "34667",
            "telephone_number": "727-862-8561",
            "fax_number": "727-861-1951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN ROBERT HAMILL, JR. M.D.P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2012-05-23",
        "status": "A",
        "authorized_official_last_name": "HAMILL",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "727-862-8561",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME0040078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gulf Coast Dermatology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hudson, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2012; 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.