Jerald Hamblin

Primary specialty

DentistTaxonomy code 122300000X

License

011945 Issued in MO

Practice address

6301 N Oak Trfy
Suite 202
Gladstone, MO 64118-4705

Phone

(816) 452-2420

NPI assigned

Dec 13, 2007

Last updated

Dec 13, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Interoperability endpoints

• Direct secure messaging: jerry.hamblin.p6@direct.360care.nextgenshare.com

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.

• Gladstone Family Dentistry L.L.C.

  • Dentist
  • Gladstone, MO
  • NPI 1730365529
  NPD (past)
• J.Reese Graue D.D.S. LLC

  dba Gladstone Family Dentistry

  • General Practice Dentistry
  • Gladstone, MO
  • NPI 1528347242
  NPD (past)

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

{
    "created_epoch": "1197504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197504000000",
    "number": "1922281971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6301 N OAK TRFY",
            "address_2": "SUITE 202",
            "city": "GLADSTONE",
            "state": "MO",
            "postal_code": "641184705",
            "telephone_number": "816-452-2420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6301 N OAK TRFY",
            "address_2": "SUITE 202",
            "city": "GLADSTONE",
            "state": "MO",
            "postal_code": "641184705",
            "telephone_number": "816-452-2420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMBLIN",
        "first_name": "JERALD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-12-13",
        "last_updated": "2007-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "011945",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "09692040",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lauren Ashley Griffin, DO
• Allen W Gross
• Chris Robert Guerrieri, DPM
• Jack Gullett
• Jennifer Brooke Halligan, DPM
• Caleb Hammond
• Steven Hankins
• Haroon Khalid MD PC (Allergy & Asthma Specialists of Kansas City)
• Jennifer Lee Hatfield Hetzel, AUD
• Stephanie Ann Head, RPH

• Dentist in Gladstone, MO
• Providers in Gladstone, MO by specialty
• Dentist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.