Individual provider Active NPI

Jennifer Ashley Hamilton, M.D.

  • Child & Adolescent Psychiatry Physician
  • Kernersville, NC
National Provider Identifier
1821520610
Registry record updated Aug 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
2022-00765 Issued in NC
Practice address
280 Broad St Ste E
Kernersville, NC 27284-2948
Phone
(336) 277-6050
Fax
(336) 992-3141
NPI assigned
Mar 30, 2017
Last updated
Aug 4, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 2022-00765 NC
Child & Adolescent Psychiatry Physician 2084P0804X 227493 NC
Child & Adolescent Psychiatry Physician 2084P0804X 2022-00765 NC Primary

Addresses

Primary practice location

280 Broad St Ste E
Kernersville, NC 27284-2948

Mailing address

PO Box 60447
Charlotte, NC 28260-0447

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220927000811 NC Practitioner - Psychiatry 6103196274 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2022-00765NCMDChild & Adolescent Psychiatry Physician
227493NCMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Forsyth Memorial Hospital, Inc Psychiatry CurrentSince Sep 1, 2022 Accepting new patients
Forsyth Memorial Hospital, Inc. Current Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC CurrentSince Sep 1, 2022 Accepting new patients
Novant Health Medical Group, LLC Psychiatry CurrentSince Sep 1, 2022 Accepting new patients
Forsyth Memorial Hospital, Inc. CurrentSince Sep 1, 2022 Accepting new patients

Locations

6301 Stadium Dr
Clemmons, NC 27012
Phone (336) 766-6473

280 Broad St
Ste E
Kernersville, NC 27284
Phone (336) 277-6050

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

309 Pineywood Rd
Thomasville, NC 27360
Phone (336) 474-8921

140 Kimel Park Dr
Ste 101
Winston Salem, NC 27103
Phone (336) 718-7280

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

Interoperability endpoints

  • Direct secure messaging: jhamilton1066100@direct.novanthealth.org

Organizations & group practices 6

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": "1490832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691107200000",
    "number": "1821520610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 BROAD ST STE E",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "272842948",
            "telephone_number": "336-277-6050",
            "fax_number": "336-992-3141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMILTON",
        "first_name": "JENNIFER",
        "middle_name": "ASHLEY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-30",
        "last_updated": "2023-08-04",
        "certification_date": "2023-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NC",
            "license": "2022-00765",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NC",
            "license": "227493",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NC",
            "license": "2022-00765",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kernersville, NC

Sources for this page

Verify at the official NPI Registry.