NPIMap

Individual provider Active NPI

Kathleen Hamrick, MD

  • Vascular & Interventional Radiology Physician
  • Chicago, IL
National Provider Identifier
1902211865
Registry record updated Jun 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
036.148593 Issued in IL
Practice address
676 N Saint Clair St Ste 800
Chicago, IL 60611-2978
Phone
(312) 695-5978
NPI assigned
Jun 30, 2014
Last updated
Jun 27, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 27, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Diagnostic Radiology Physician 2085R0202X 036.148593 IL
Vascular & Interventional Radiology Physician 2085R0204X 036.148593 IL Primary

Addresses

Primary practice location

676 N Saint Clair St Ste 800
Chicago, IL 60611-2978

Mailing address

676 N Saint Clair St Ste 800
Chicago, IL 60611-2978
Phone (312) 695-5978

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200723001216 TN Practitioner - Diagnostic RadiologyPractitioner - Interventional Radiology 5991030405 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic RadiologyAlso: Interventional Radiology
Education
University of Alabama School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jackson Radiology Associates PAGroup PAC ID 6305893231, 28 clinicians

Practice addresses (Care Compare)

620 Skyline Dr
Jackson, TN 38301-3923
Phone (731) 541-5000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.15 of 100Reported as group
Quality
74.15
Promoting interoperability
77
Improvement activities
40
Cost
78.84

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal17
Leg revascularization (restoring blood flow)1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Imaging of Tennessee CurrentSince Aug 1, 2020 Accepting new patients
Jackson Clinic PA Diagnostic Radiology CurrentSince Aug 1, 2020 Accepting new patients
Jackson Clinic PA CurrentSince Aug 1, 2020 Accepting new patients
Jackson Radiology Associates PA Diagnostic Radiology CurrentSince Aug 17, 2020 Accepting new patients
Jackson Madison County General Hospital Diagnostic Radiology CurrentSince Oct 1, 2025 Accepting new patients

Locations

650 Nuckolls Rd
Bolivar, TN 38008
Phone (731) 541-6834

244 Coatsland Dr
Jackson, TN 38301
Phone (731) 422-4642

2859 Highway 45 Byp
Jackson, TN 38305
Phone (731) 660-8360

620 Skyline Dr
Jackson, TN 38301
Phone (731) 541-4923

87 Murray Guard Dr
Ste B
Jackson, TN 38305
Phone (731) 664-1375

Organizations & group practices 5

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.

Hospital & facility affiliations 5

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": "1404086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561593600000",
    "number": "1902211865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "676 N SAINT CLAIR ST STE 800",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112978",
            "telephone_number": "312-695-5978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "676 N SAINT CLAIR ST STE 800",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112978",
            "telephone_number": "312-695-5978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMRICK",
        "first_name": "KATHLEEN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-30",
        "last_updated": "2019-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "036.148593",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "IL",
            "license": "036.148593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.