Organization Active NPI

Hometown Direct Primary Care PLLC

  • Primary Care Clinic/Center
  • Coats, NC
National Provider Identifier
1164042412
Registry record updated Apr 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
HOMETOWN DIRECT PRIMARY CARE PLLC
Practice address
124 E Stewart St
Coats, NC 27521-8352
Phone
(919) 901-7344
Fax
(877) 807-8251
NPI assigned
Apr 16, 2020
Last updated
Apr 10, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2025

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

Authorized official

Name
Crystal B Rambeau, MDNPI 1518930783
Title
Owner
Phone
(919) 901-7344

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

124 E Stewart St
Coats, NC 27521-8352

Mailing address

3949 Chalybeate Springs Rd
Fuquay Varina, NC 27526-6207
Phone (919) 910-7344

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200708003652 NC Part B Supplier - Clinic/Group Practice 9638592686 Receives reassigned benefits from 1 practitioner
Practice locations: Coats, NC

National Provider Directory

National Provider Directory

Locations

124 E Stewart St
Coats, NC 27521
Phone (919) 901-7344

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1586995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744243200000",
    "number": "1164042412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3949 CHALYBEATE SPRINGS RD",
            "city": "FUQUAY VARINA",
            "state": "NC",
            "postal_code": "275266207",
            "telephone_number": "919-910-7344",
            "fax_number": "319-250-7453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 E STEWART ST",
            "city": "COATS",
            "state": "NC",
            "postal_code": "275218352",
            "telephone_number": "919-901-7344",
            "fax_number": "877-807-8251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOMETOWN DIRECT PRIMARY CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-16",
        "last_updated": "2025-04-10",
        "certification_date": "2025-04-10",
        "status": "A",
        "authorized_official_last_name": "RAMBEAU",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "919-901-7344",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coats, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.