Active NPI
Andrew L Hamby, MD
- Pediatrics Physician
- Tyler, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- V0415
- Practice address
- 706 Turtle Creek Dr
Tyler, TX 75701-1833 - Phone
- (903) 595-3942
- NPI assigned
- Jul 3, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | E-9583 | AR | |
| Pediatrics Physician | 208000000X | 2003020131 | MO | |
| Pediatrics Physician | 208000000X | V0415 | TX | Primary |
Addresses
Primary practice location
706 Turtle Creek Dr
Tyler, TX 75701-1833
Mailing address
#1 Children'S Way, Slot 844
Acmg
Little Rock, AR 72202-3500
Phone (501) 364-2090
Other practice location 1
2601 Gene George Blvd
Springdale, AR 72762-0845
Phone (479) 725-6880
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 181341 | Other | MO | ANTHEM |
| 215364001 | Medicaid | AR | |
| 200014340A | Medicaid | OK | |
| 100643070A | Medicaid | KS | |
| 209083005 | Medicaid | MO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AR, TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2003020131 | MO | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northwest Benton County Physician Services LLC | Current | Accepting new patients | |
| Christus Trinity Clinic Texas | Current | Accepting new patients | |
| Christus Trinity Clinic Texas | Pediatrics | Current | Accepting new patients |
| Trinity Clinic | Past | Accepting new patients |
Locations
101 Sun Meadow Dr
Centerton, AR 72719
Phone (479) 273-1426
630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888
706 Turtle Creek Dr
Tyler, TX 75701
Phone (903) 593-1786
Organizations & group practices 4
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.
-
- Family Medicine Physician
- Bentonville, AR
- NPI 1871553073
-
- Rural Health Clinic/Center
- Winnsboro, TX
- NPI 1801673165
-
- Family Medicine Physician
- Tyler, TX
- NPI 1922058304
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151884800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1726790400000",
"number": "1760412209",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "#1 CHILDREN'S WAY, SLOT 844",
"address_2": "ACMG",
"city": "LITTLE ROCK",
"state": "AR",
"postal_code": "722023500",
"telephone_number": "501-364-2090",
"fax_number": "501-364-3929"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "706 TURTLE CREEK DR",
"city": "TYLER",
"state": "TX",
"postal_code": "757011833",
"telephone_number": "903-595-3942"
}
],
"practiceLocations": [
{
"address_1": "2601 Gene George Blvd",
"address_purpose": "LOCATION",
"city": "Springdale",
"state": "AR",
"postal_code": "727620845",
"country_code": "US",
"telephone_number": "479-725-6880",
"fax_number": "479-725-6582",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HAMBY",
"first_name": "ANDREW",
"middle_name": "L",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-03",
"last_updated": "2024-09-20",
"certification_date": "2024-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "AR",
"license": "E-9583",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MO",
"license": "2003020131",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "TX",
"license": "V0415",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "181341",
"state": "MO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "215364001",
"state": "AR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200014340A",
"state": "OK"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100643070A",
"state": "KS"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "209083005",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Tyler, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.