Jeffery Allan Hamilton, APRN
Individual provider Active NPI Primary Care Nurse Practitioner · Pendleton, KY
NPI 1962097428 · NPPES record last updated Mar 6, 2021
Key facts
- NPI
- 1962097428
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Primary Care Nurse Practitioner 363LP2300X
- License
- 3015868 (KY)
- Practice address
- 282 Yates LN
Pendleton, KY 40055-7751 - Phone
- (502) 377-1792
- NPI assigned
- Mar 6, 2021
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 5
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- S Kapoor PLLC
Practice addresses (Care Compare)
2109 Club Vista PL
Louisville, KY 40245-5224
Phone (502) 602-4620
Hospital & facility affiliations
- Baptist Health Lagrange
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20211015002197 | KY | Practitioner - Nurse Practitioner | 8628476926 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3015868 | KY | MD | Primary Care Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| S Kapoor PLLC | Current |
Accepting new patients | |
| Provider Partners Care Management LP | Current |
Accepting new patients | |
| SKG Health PLLC | Current |
Accepting new patients | |
| Sangeeta Kapoor, PLLC | Past | Accepting new patients |
Locations
50 Shepherd Ln
Bedford, KY 40006
Phone (502) 255-3244
446 Mount Holly Ave
Louisville, KY 40206
Phone (502) 897-1646
2509 Plantside Dr
Louisville, KY 40299
Phone (502) 830-0321
8820 Columbia 100 Pkwy
Ste 430
Columbia, MD 21045
Phone (410) 967-2097
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Nurse Practitioner | 363LP2300X | 3015868 | KY | Yes |
Addresses
Primary practice location
282 Yates LN
Pendleton, KY 40055-7751
Mailing address
282 Yates LN
Pendleton, KY 40055-7751
Phone (502) 377-1792
Other providers in Pendleton, KY
All providers in Pendleton, KY · Primary Care Nurse Practitioner in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 6, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.