Hometown Healthcare and Pediatrics LLC

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

HOMETOWN HEALTHCARE AND PEDIATRICS LLC

Practice address

315 N Main St
Trenton, FL 32693-3462

Phone

(352) 246-8566

Fax

(734) 322-0384

NPI assigned

May 25, 2022

Organization subpart

No

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

Authorized official

Name

Kristen Welch

Title

Office Manager

Phone

(352) 246-8566

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Rural health clinic certification: CCN 683844

Legal name

HOMETOWN HEALTHCARE AND PEDIATRICS LLC

Certification status

Active

Provider type (POS)

Rural health clinic

Participating since

Oct 28, 2022

Last certification

Oct 28, 2022

Ownership / control type

For profit – corporation

Organization structure

LLCProprietary

Incorporated

Jan 24, 2022 in FL

Enrollment address

315 N Main St
Trenton, FL 32693-3462

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 2

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

Practitioners 4

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

• Sarah Bradshaw, APRN

  • Family Nurse Practitioner
  • Trenton, FL
  • NPI 1528812609
  NPD
• Michele Lyn Coleman, ARNP

  • Pediatric Nurse Practitioner
  • Trenton, FL
  • NPI 1568741445
  NPD
• John F Brandt, MD

  • Family Medicine Physician
  • Gainesville, FL
  • NPI 1689606030

  Family Medicine

  NPD (past)
• Brooke Lamour Lounsbury

  • Family Nurse Practitioner
  • Trenton, FL
  • NPI 1235887118
  NPD (past)

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

{
    "created_epoch": "1653436800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672963200000",
    "number": "1235877697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22856 SW 46TH AVE",
            "city": "NEWBERRY",
            "state": "FL",
            "postal_code": "326694713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 N MAIN ST",
            "city": "TRENTON",
            "state": "FL",
            "postal_code": "326933462",
            "telephone_number": "352-246-8566",
            "fax_number": "734-322-0384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOMETOWN HEALTHCARE AND PEDIATRICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-25",
        "last_updated": "2023-01-06",
        "certification_date": "2022-06-03",
        "status": "A",
        "authorized_official_last_name": "WELCH",
        "authorized_official_first_name": "KRISTEN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "352-246-8566"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "116287400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kimberly Henderson, LCSW
• Henrique F. Silva DDS PLLC
• Kimberly Carpenter Herring, M.S.W., L.C.S.W.
• Savannah Hickman, PA-C
• Home Respiratory Solutions, Inc.
• Lillian E Hummer, RN, BSN, PAC, CNM
• James Ivey, MD
• Camille Jefferson, FNP-C
• Sujin Ju, D.M.D.
• Susan Marlene Kennedy

• All providers in Trenton, FL
• Rural Health Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2023; 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.