Active NPI
Glenn D Hamilton, MD
- Family Medicine Physician
- Wilmington, DE
National Provider Identifier
1831206754
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MD042891E
- Practice address
- 777 Delaware Park Blvd
Wilmington, DE 19804-4122 - Phone
- (302) 994-3166
- Fax
- (775) 923-9397
- NPI assigned
- Aug 24, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MD042891E | PA | Primary |
Addresses
Primary practice location
777 Delaware Park Blvd
Wilmington, DE 19804-4122
Mailing address
7 Quigley LN
Garnet Valley, PA 19061-1234
Phone (610) 358-9965
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0701881000 | Other | KEYSTONE | |
| 01873711 | Medicaid | PA | |
| 2045582 | Other | BCBS PA | |
| 01-24638 | Other | EVERCARE |
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
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Personic Virtual Clinic LLC | Past | Accepting new patients |
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 and National Provider Directory roles.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156377600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1232928000000",
"number": "1831206754",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7 QUIGLEY LN",
"city": "GARNET VALLEY",
"state": "PA",
"postal_code": "190611234",
"telephone_number": "610-358-9965",
"fax_number": "775-923-9397"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "777 DELAWARE PARK BLVD",
"city": "WILMINGTON",
"state": "DE",
"postal_code": "198044122",
"telephone_number": "302-994-3166",
"fax_number": "775-923-9397"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAMILTON",
"first_name": "GLENN",
"middle_name": "D",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-24",
"last_updated": "2009-01-26",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "PA",
"license": "MD042891E",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KEYSTONE",
"identifier": "0701881000",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01873711",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS PA",
"identifier": "2045582",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EVERCARE",
"identifier": "01-24638",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Wilmington, DE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.