Individual provider Active NPI

Randall Ray Hamilton, NP

  • Adult Health Nurse Practitioner
  • Phoenix, AZ
National Provider Identifier
1780695452
Registry record updated Mar 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
AP1481 Issued in AZ
Practice address
19636 N 27TH Ave
Suite 106
Phoenix, AZ 85027
Phone
(623) 516-8252
Fax
(623) 516-8253
NPI assigned
Aug 10, 2006
Last updated
Mar 19, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X AP1481 AZ Primary

Addresses

Primary practice location

19636 N 27TH Ave
Suite 106
Phoenix, AZ 85027

Mailing address

5281 N 99TH Ave
Suite 100
Glendale, AZ 85305-3105
Phone (623) 516-8252

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)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Scottsdale Bariatric Center Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: randall.hamilton.1@17515.direct.athenahealth.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395187200000",
    "number": "1780695452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5281 N 99TH AVE",
            "address_2": "SUITE 100",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853053105",
            "telephone_number": "623-516-8252",
            "fax_number": "623-516-8253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19636 N 27TH AVE",
            "address_2": "SUITE 106",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85027",
            "telephone_number": "623-516-8252",
            "fax_number": "623-516-8253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMILTON",
        "first_name": "RANDALL",
        "middle_name": "RAY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-10",
        "last_updated": "2014-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AZ",
            "license": "AP1481",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2014; 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.