NPIMap

Organization Active NPI

Homefront Family Services

  • Speech-Language Pathologist
  • Greentown, IN
National Provider Identifier
1073789467
Registry record updated May 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
22004012 Issued in IN
Legal business name
HOMEFRONT FAMILY SERVICES
Practice address
9909 E 100 S
Greentown, IN 46936-9163
Phone
(765) 628-0605
Fax
(765) 628-3639
NPI assigned
May 5, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2008

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

Authorized official

Name
Amy Ellis
Title
Owner
Phone
(765) 628-0605

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nutrition Registered DietitianGroup: 193200000X MULTI-SPECIALTY GROUP 133VN1004X 37001000 IN
Pediatric Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 2251P0200X 05006820 IN
Pediatric Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225XP0200X 31002242 IN
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X 22004012 IN Primary

Addresses

Primary practice location

9909 E 100 S
Greentown, IN 46936-9163

Mailing address

9909 E 100 S
Greentown, IN 46936-9163
Phone (765) 628-0605

Other identifiers 1

IdentifierTypeStateIssuer
200728940MedicaidIN

National Provider Directory

National Provider Directory
Tax ID family
Homefront Family Services2 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.

Practitioners & affiliated clinicians

Practitioners 26

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

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1209945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209945600000",
    "number": "1073789467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9909 E 100 S",
            "city": "GREENTOWN",
            "state": "IN",
            "postal_code": "469369163",
            "telephone_number": "765-628-0605",
            "fax_number": "765-628-3639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9909 E 100 S",
            "city": "GREENTOWN",
            "state": "IN",
            "postal_code": "469369163",
            "telephone_number": "765-628-0605",
            "fax_number": "765-628-3639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOMEFRONT FAMILY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-05",
        "last_updated": "2008-05-05",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "765-628-0605"
    },
    "taxonomies": [
        {
            "code": "133VN1004X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dietitian, Registered, Nutrition, Pediatric",
            "state": "IN",
            "license": "37001000",
            "primary": false
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Pediatrics",
            "state": "IN",
            "license": "05006820",
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "IN",
            "license": "31002242",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "IN",
            "license": "22004012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200728940",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greentown, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.