Individual provider Active NPI

David Theodore Hamilos

  • Foot & Ankle Surgery Podiatrist
  • Johnson City, TN
National Provider Identifier
1811986490
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
000284 Issued in TN
Practice address
508 Princeton Rd
Ste 202
Johnson City, TN 37601-2063
Phone
(423) 926-2741
Fax
(423) 926-5782
NPI assigned
Oct 17, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 000284 TN Primary

Addresses

Primary practice location

508 Princeton Rd
Ste 202
Johnson City, TN 37601-2063

Mailing address

508 Princeton Rd
Suite 202
Johnson City, TN 37601-2060
Phone (423) 926-2741

Other identifiers 3

IdentifierTypeStateIssuer
85440OtherTNBCBS OF TENNESSEE
3351538MedicaidTN
000284OtherTNTN PODIATRY LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040901000331 TN Practitioner - Podiatry 9436124526 Practice locations: Johnson City, TN

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

508 Princeton Rd
Johnson City, TN 37601-2063
Phone (423) 926-2741

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue376
Removal of nail tissue600
Removal or shaving of skin growth148

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
000284TNMDFoot & Ankle Surgery Podiatrist

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1129507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1811986490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "508 PRINCETON RD",
            "address_2": "SUITE 202",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376012060",
            "telephone_number": "423-926-2741",
            "fax_number": "423-926-5782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 PRINCETON RD",
            "address_2": "STE 202",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376012063",
            "telephone_number": "423-926-2741",
            "fax_number": "423-926-5782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMILOS",
        "first_name": "DAVID",
        "middle_name": "THEODORE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-17",
        "last_updated": "2026-07-13",
        "certification_date": "2020-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "TN",
            "license": "000284",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF TENNESSEE",
            "identifier": "85440",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3351538",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TN  PODIATRY LICENSE",
            "identifier": "000284",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

Verify at the official NPI Registry.