Individual provider Active NPI

Mary Pat Hamilton, M.D.

  • Emergency Medical Services (Emergency Medicine) Physician
  • Bedford, VA
National Provider Identifier
1861439002
Registry record updated Jul 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X
License
0101102768 Issued in VA
Practice address
1953 Shepherds Store Rd
Bedford, VA 24523-5510
Phone
(540) 494-0505
NPI assigned
May 31, 2006
Last updated
Jul 25, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 25, 2017

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 32199 TN
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X 26401 WV
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X 32199 TN
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X 0101102768 VA Primary

Addresses

Primary practice location

1953 Shepherds Store Rd
Bedford, VA 24523-5510

Mailing address

1953 Shepherds Store Rd
Bedford, VA 24523-5510
Phone (540) 494-0505

Other identifiers 1

IdentifierTypeStateIssuer
5881421MedicaidVA

Other names 1

  • Dr. Mary Hamilton Valley Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20141205001644 WV Practitioner - Emergency Medicine 8527961135 Reassigns benefits to 1 organization
I20160517000877 TX Practitioner - Internal MedicinePractitioner - Emergency Medicine 8527961135 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
32199TNMDEmergency Medicine Physician
0101102768VAMDEmergency Medical Services (Emergency Medicine) Physician
26401WVMDEmergency Medical Services (Emergency Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rosebud Indian Health Service CurrentSince Apr 19, 2016 Accepting new patients
Beckley Emergency Physicians LLC Emergency Medicine CurrentSince May 9, 2015 Accepting new patients
Lawton Indian Hospital CurrentSince Mar 11, 2022 Accepting new patients
Rosebud Indian Health Service CurrentSince Apr 19, 2016 Accepting new patients
Emergency Coverage Services, PC Past Accepting new patients
Community Physicians Services Corporation Past Accepting new patients
Richlands Volunteer Rescue Squad, Inc. PastSince Dec 27, 2005 Accepting new patients
Dan River Emergency Services LLC Emergency Medicine Past Accepting new patients

Locations

1515 NE Lawrie Tatum Rd
Lawton, OK 73507
Phone (580) 353-0350

306 Stanaford Rd
Beckley, WV 25801
Phone (304) 255-3373

Organizations & group practices 8

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": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1500940800000",
    "number": "1861439002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1953 SHEPHERDS STORE RD",
            "city": "BEDFORD",
            "state": "VA",
            "postal_code": "245235510",
            "telephone_number": "540-494-0505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1953 SHEPHERDS STORE RD",
            "city": "BEDFORD",
            "state": "VA",
            "postal_code": "245235510",
            "telephone_number": "540-494-0505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMILTON",
        "first_name": "MARY",
        "middle_name": "PAT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-31",
        "last_updated": "2017-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "32199",
            "primary": false
        },
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "WV",
            "license": "26401",
            "primary": false
        },
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "TN",
            "license": "32199",
            "primary": false
        },
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "VA",
            "license": "0101102768",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5881421",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "VALLEY",
            "middle_name": "HAMILTON",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bedford, VA

Sources for this page

Verify at the official NPI Registry.