NPIMap

Individual provider Active NPI

Bradley Hamilton, PA-C

  • Physician Assistant
  • Lawton, OK
National Provider Identifier
1902320468
Registry record updated Mar 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
4403 Issued in OK
Practice address
3401 W Gore Blvd
Lawton, OK 73505-6332
Phone
(580) 355-8620
NPI assigned
Jul 26, 2017
Last updated
Mar 17, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 3608 TN
Physician Assistant 363A00000X PA11404 TX
Physician Assistant 363A00000X 4403 OK Primary

Addresses

Primary practice location

3401 W Gore Blvd
Lawton, OK 73505-6332

Mailing address

14800 Daventry Dr
Jones, OK 73049-9624

Other practice location 1

7700 Cat Hollow Dr Ste 101
Round Rock, TX 78681-5797
Phone (512) 255-8888

Other practice location 2

5546 Highway 153 Ste 120
Hixson, TN 37343-5329
Phone (423) 486-1911

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20210322001863 OK Practitioner - Physician Assistant 4587930623 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ehp of Ponca City LLCGroup PAC ID 1850828948, 21 clinicians
Elite Hospital Partners of OklahomaGroup PAC ID 6800241225, 24 clinicians

Practice addresses (Care Compare)

1900 N 14TH St
Ponca City, OK 74601-2035
Phone (580) 765-3321

5602 SW Lee Blvd
Lawton, OK 73505-9635
Phone (580) 531-4700

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ehp of Ponca City LLC CurrentSince Oct 16, 2025 Accepting new patients
Comanche County Hospital Authority Past Accepting new patients

Locations

1900 N 14th St
Ponca City, OK 74601
Phone (580) 718-2932

Interoperability endpoints

  • Direct secure messaging: bhamilton1139373@directc.mercy.net
  • Direct secure messaging: bradleyhamilton@tnmhpf.allscriptsdirect.net

Organizations & group practices 4

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 4

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": "1501027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615939200000",
    "number": "1902320468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14800 DAVENTRY DR",
            "city": "JONES",
            "state": "OK",
            "postal_code": "730499624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 W GORE BLVD",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735056332",
            "telephone_number": "580-355-8620"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7700 Cat Hollow Dr Ste 101",
            "address_purpose": "LOCATION",
            "city": "Round Rock",
            "state": "TX",
            "postal_code": "786815797",
            "country_code": "US",
            "telephone_number": "512-255-8888",
            "fax_number": "512-248-9451",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5546 Highway 153 Ste 120",
            "address_purpose": "LOCATION",
            "city": "Hixson",
            "state": "TN",
            "postal_code": "373435329",
            "country_code": "US",
            "telephone_number": "423-486-1911",
            "fax_number": "423-486-1912",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAMILTON",
        "first_name": "BRADLEY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-26",
        "last_updated": "2021-03-17",
        "certification_date": "2021-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "3608",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA11404",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "4403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawton, OK

Sources for this page

Verify at the official NPI Registry.