Active NPI
Kim Scott Hamelberg, MD.
- Surgery Physician
- Westerville, OH
National Provider Identifier
1881699759
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 35057243
- Practice address
- 495 Cooper Rd
Ste 430
Westerville, OH 43081-8723 - Phone
- (614) 508-0001
- Fax
- (614) 508-0008
- NPI assigned
- Jun 16, 2005
- 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 |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 35057243 | OH | Primary |
Addresses
Primary practice location
495 Cooper Rd
Ste 430
Westerville, OH 43081-8723
Mailing address
495 Cooper Rd
Ste 430
Westerville, OH 43081-8723
Phone (614) 508-0001
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0820946 | Medicaid | OH |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35057243 | OH | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Riverside Trauma Surgeons 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.
-
- Trauma Surgery Physician
- Columbus, OH
- NPI 1275674673
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1118880000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1193702400000",
"number": "1881699759",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "495 COOPER RD",
"address_2": "STE 430",
"city": "WESTERVILLE",
"state": "OH",
"postal_code": "430818723",
"telephone_number": "614-508-0001",
"fax_number": "614-508-0008"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "495 COOPER RD",
"address_2": "STE 430",
"city": "WESTERVILLE",
"state": "OH",
"postal_code": "430818723",
"telephone_number": "614-508-0001",
"fax_number": "614-508-0008"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAMELBERG",
"first_name": "KIM",
"middle_name": "SCOTT",
"credential": "MD.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-06-16",
"last_updated": "2007-10-30",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "OH",
"license": "35057243",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0820946",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Westerville, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.