Hometown Pediatrics LLC

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

Legal business name

HOMETOWN PEDIATRICS LLC

Practice address

108 N 4TH St
Vienna, GA 31092-1115

Phone

(229) 231-5008

Fax

(229) 231-5539

NPI assigned

Jan 30, 2023

Organization subpart

No

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

Authorized official

Name

Haley Ellis Pullen, FNPNPI 1932748894

Title

Owner

Phone

(850) 688-0943

Specialties & licenses 1

Addresses

Other identifiers 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

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

• Haley Ellis Pullen

  • Family Nurse Practitioner
  • Vienna, GA
  • NPI 1932748894
  NPD Authorized official
• Emily Michele Turner, FNP

  • Family Nurse Practitioner
  • Vienna, GA
  • NPI 1245123249
  NPD

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

{
    "created_epoch": "1675036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675036800000",
    "number": "1013623263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 N 4TH ST",
            "city": "VIENNA",
            "state": "GA",
            "postal_code": "310921115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 N 4TH ST",
            "city": "VIENNA",
            "state": "GA",
            "postal_code": "310921115",
            "telephone_number": "229-231-5008",
            "fax_number": "229-231-5539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOMETOWN PEDIATRICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-30",
        "last_updated": "2023-01-30",
        "certification_date": "2023-01-30",
        "status": "A",
        "authorized_official_last_name": "PULLEN",
        "authorized_official_first_name": "HALEY",
        "authorized_official_middle_name": "ELLIS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "850-688-0943",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1932748894",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dooly County Commissioner of Roads and Revenues
• Dooly County School System
• Forbes Drug Inc
• High Cotton Homes, LLC
• Homecare & Medical Systems of Georgia Inc
• Mark M Ingram, DMD
• Darrian Bailey Krause
• Tacarro Lawrence,, PBT
• Winiferd Merrell, CNA
• Middle Flint Community Service Board

• All providers in Vienna, GA
• Medical Specialty Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.