NPIMap

Organization Active NPI

Kevin Hamilton DC-PC

  • Chiropractor
  • Davenport, IA
National Provider Identifier
1912299355
Registry record updated Feb 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
A05394 Issued in IA
Legal business name
KEVIN HAMILTON DC-PC
Practice address
3719 Bridge Ave
Suite 2
Davenport, IA 52807-1807
Phone
(563) 344-6060
Fax
(563) 344-6061
NPI assigned
May 4, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2014

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

Authorized official

Name
Dr. Kevin D Hamilton, DCNPI 1831141522
Title
Owner/Doctor of Chiropractic
Phone
(563) 344-6060

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X A05394 IA Primary

Addresses

Primary practice location

3719 Bridge Ave
Suite 2
Davenport, IA 52807-1807

Mailing address

3719 Bridge Ave
Suite 2
Davenport, IA 52807-1807
Phone (563) 344-6060

Other identifiers 2

IdentifierTypeStateIssuer
05686OtherIAWELLMARK BLUE CROSS BLUE SHIELD
0747485MedicaidIA

Other names 1

  • Elmore Chiropractic Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110512000350 IA Part B Supplier - Clinic/Group Practice 1355527185 Receives reassigned benefits from 1 practitioner
Practice locations: Davenport, IA

National Provider Directory

National Provider Directory
Tax ID family
Elmore Chiropractic2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3719 Bridge Ave
Ste 2
Davenport, IA 52807
Phone (563) 344-6060

2028 E 38th St
Ste 2
Davenport, IA 52807
Phone (563) 344-6060

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1304467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1391990400000",
    "number": "1912299355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3719 BRIDGE AVE",
            "address_2": "SUITE 2",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528071807",
            "telephone_number": "563-344-6060",
            "fax_number": "563-344-6061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3719 BRIDGE AVE",
            "address_2": "SUITE 2",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528071807",
            "telephone_number": "563-344-6060",
            "fax_number": "563-344-6061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEVIN HAMILTON DC-PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-04",
        "last_updated": "2014-02-10",
        "status": "A",
        "authorized_official_last_name": "HAMILTON",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER/DOCTOR OF CHIROPRACTIC",
        "authorized_official_telephone_number": "563-344-6060",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "A05394",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK BLUE CROSS BLUE SHIELD",
            "identifier": "05686",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0747485",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Elmore Chiropractic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Davenport, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.