Individual provider Active NPI

Susan Lea Hamilton, LPN

  • Licensed Practical Nurse
  • Tulsa, OK
National Provider Identifier
1760110886
Registry record updated Dec 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
0039560 Issued in OK
Practice address
102 N Denver Ave
Tulsa, OK 74103-1806
Phone
(918) 582-1200
NPI assigned
Aug 9, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 0039560 OK Primary

Addresses

Primary practice location

102 N Denver Ave
Tulsa, OK 74103-1806

Mailing address

102 N Denver Ave
Tulsa, OK 74103-1806
Phone (918) 582-1200

Other practice location 1

1055 S Houston Ave
Tulsa, OK 74127-9043
Phone (918) 921-3200

Other practice location 2

1 W 36th St N
Tulsa, OK 74106-1700
Phone (918) 425-4200

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
0039560OKMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1660003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735516800000",
    "number": "1760110886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 N DENVER AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741031806",
            "telephone_number": "918-582-1200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 N DENVER AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741031806",
            "telephone_number": "918-582-1200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1055 S Houston Ave",
            "address_purpose": "LOCATION",
            "city": "Tulsa",
            "state": "OK",
            "postal_code": "741279043",
            "country_code": "US",
            "telephone_number": "918-921-3200",
            "fax_number": "918-560-1399",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 W 36th St N",
            "address_purpose": "LOCATION",
            "city": "Tulsa",
            "state": "OK",
            "postal_code": "741061700",
            "country_code": "US",
            "telephone_number": "918-425-4200",
            "fax_number": "918-560-1399",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAMILTON",
        "first_name": "SUSAN",
        "middle_name": "LEA",
        "name_prefix": "Mrs.",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-09",
        "last_updated": "2024-12-30",
        "certification_date": "2024-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OK",
            "license": "0039560",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 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.