Hillary J Homburg, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

3870 Issued in WV

Practice address

6135 Sissonville Dr
Charleston, WV 25312-9444

Phone

(304) 984-1576

Fax

(304) 984-1565

NPI assigned

Apr 23, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WV

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

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: hillary.homburg.1@7267.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Cabin Creek Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Dawes, WV
  • NPI 1366495525
  Medicare reassignment NPD
• Cabin Creek Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Charleston, WV
  • NPI 1194596759
  NPD
• Cabin Creek Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Charleston, WV
  • NPI 1588908362
  NPD
• New River Health Association, Inc.

  • Federally Qualified Health Center (FQHC)
  • Beckley, WV
  • NPI 1033088331
  NPD (past)

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

{
    "created_epoch": "1240444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590019200000",
    "number": "1114161940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 ALEX LN",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253042952",
            "telephone_number": "304-734-2040",
            "fax_number": "304-734-2047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6135 SISSONVILLE DR",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253129444",
            "telephone_number": "304-984-1576",
            "fax_number": "304-984-1565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOMBURG",
        "first_name": "HILLARY",
        "middle_name": "J",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-23",
        "last_updated": "2020-05-21",
        "certification_date": "2020-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WV",
            "license": "3970",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "IN PROCESS",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WV",
            "license": "3870",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810018626",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda Holt
• Andrew Holt
• Hope Holt
• Ashley J Holtsclaw
• Johnny Levi Holtzman, MD
• Home Base Inc.
• Home Base Inc.
• Home Care Medical Equipment
• Deborah Honaker Ross
• Brittny Honaker, RN

• Dentist in Charleston, WV
• Providers in Charleston, WV by specialty
• Dentist in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2020; 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.