Hometown Healthcare LLC

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

License

PA04256 Issued in TX

Legal business name

HOMETOWN HEALTHCARE LLC

Doing business as

Garfield Medical Clinic

Practice address

404 E San Marcos St
Pearsall, TX 78061-3226

Phone

(830) 334-3336

Fax

(830) 334-5574

NPI assigned

Apr 28, 2010

Last updated

Jun 9, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Will D Thompson, PANPI 1659310175

Title

President

Phone

(830) 879-2279

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Garfield Medical Clinic Doing business as

Medicare fee-for-service enrollment

Enrolled in TX2 enrollments

Enrollment records 2

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1184941346. Details of each certification follow.

• CCN 673909 Rural health clinic · Active · Details

Rural health clinic certification: CCN 673909

Legal name

HOMETOWN HEALTHCARE LLC

Certification status

Active

Provider type (POS)

Rural health clinic

Participating since

Aug 24, 2009

Last certification

Jun 1, 2016

Ownership / control type

1B

Organization structure

LLCProprietary

Incorporated

Mar 30, 2010 in TX

Enrollment address

404 E San Marcos St
Pearsall, TX 78061-3226

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Hometown Healthcare LLC

  • Rural Health Clinic/Center
  • Cotulla, TX
  • NPI 1881911030

  2567595424

  Same PAC ID

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Hometown Healthcare LLC

  • Family Medicine Physician
  • Orange Grove, TX
  • NPI 1255851465

  O20171102002256

  Same enrollment
• Hometown Healthcare LLC

  dba Garfield Medical Clinic

  • Rural Health Clinic/Center
  • Dilley, TX
  • NPI 1538486790

  O20171102002256

  Same enrollment
• Hometown Healthcare LLC

  • Rural Health Clinic/Center
  • Cotulla, TX
  • NPI 1881911030

  O20171102002256

  Same enrollment

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

All disclosed owners & managing parties 1

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Will Donn Thompson, MPAS, PA-C

  • Physician Assistant
  • Orange Grove, TX
  • NPI 1659310175

  5% Or Greater Direct Ownership Interest, 5% Or Greater Mortgage Interest, 5% Or Greater Security Interest, Corporate Officer, Operational/Managerial Control, W-2 Managing Employee

  CMS ownership

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.

• Will Donn Thompson, MPAS, PA-C

  • Physician Assistant
  • Orange Grove, TX
  • NPI 1659310175
  NPD (past) Authorized official

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

{
    "created_epoch": "1272412800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1496966400000",
    "number": "1184941346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P. O. BOX 2070",
            "city": "ORANGE GROVE",
            "state": "TX",
            "postal_code": "783722070",
            "telephone_number": "830-879-2279",
            "fax_number": "830-879-2235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 E SAN MARCOS ST",
            "city": "PEARSALL",
            "state": "TX",
            "postal_code": "780613226",
            "telephone_number": "830-334-3336",
            "fax_number": "830-334-5574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOMETOWN HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-28",
        "last_updated": "2017-06-09",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "WILL",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "830-879-2279",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PA"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "TX",
            "license": "PA04256",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "281495602",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "281495601",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Garfield Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jeffrey Eugene Haug, RPH
• Herbert I Garfield (Garfield Medical Clinic)
• Jesus Leonardo Hernandez, DDS
• Steven Herrera
• Mitzy Camilla Hill, MS, LPC
• Alberto Ignacio Infante
• Jaime N Hernandez (Wintergarden Mobility Repair & Supplies)
• Alyssa Makayla Jasso
• Ivan Jorge Juarez, PHARMD, RPH
• Lori Jean Keck

• Rural Health Clinic/Center in Pearsall, TX
• Providers in Pearsall, TX by specialty
• Rural Health Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.