NPIMap

Organization Active NPI

Hometown Healthcare Inc

  • Durable Medical Equipment & Medical Supplies
  • Fulton, MS
National Provider Identifier
1417656174
Registry record updated Mar 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
HOMETOWN HEALTHCARE INC
Practice address
709 S Adams St
Fulton, MS 38843-4404
Phone
(662) 862-7828
Fax
(662) 862-7294
NPI assigned
Mar 1, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2023

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

Authorized official

Name
Kevin S Kilgore
Title
President
Phone
(662) 456-4630

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

709 S Adams St
Fulton, MS 38843-4404

Mailing address

107 E Washington St
Houston, MS 38851-2225
Phone (662) 456-4630

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230531002201 MS DME Supplier - Medical Supply Company With Respiratory Therapist 3274734504 Practice locations: Fulton, MS

Other NPIs with the same Medicare PAC ID 11

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Hometown Healthcare, Inc.709 S Adams St, Fulton, MS 38843-4404(662) 862-7828 Automatic Ext Defibrillator (AEDS) and/or Supplies|Commodes, Urinals, Bedpans|Contracture Treatment Devices: Dynamic Splint|Blood Glucose Monitors/Supplies (Non-Mail Order)|Blood Glucose Monitors/Supplies (Mail Order)|Hospital Beds (Electric)|Hospital Beds (Manual)|Negative Pressure Wound Therapy P… Does not accept assignmentParticipating since Jul 25, 2005

National Provider Directory

National Provider Directory
Tax ID family
Hometown Healthcare Inc13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1677628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677628800000",
    "number": "1417656174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 E WASHINGTON ST",
            "city": "HOUSTON",
            "state": "MS",
            "postal_code": "388512225",
            "telephone_number": "662-456-4630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "709 S ADAMS ST",
            "city": "FULTON",
            "state": "MS",
            "postal_code": "388434404",
            "telephone_number": "662-862-7828",
            "fax_number": "662-862-7294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOMETOWN HEALTHCARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-01",
        "last_updated": "2023-03-01",
        "certification_date": "2023-03-01",
        "status": "A",
        "authorized_official_last_name": "KILGORE",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "662-456-4630"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fulton, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.