Hometown Healthcare of Elkins LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

04D2045431 Issued in AR

Legal business name

HOMETOWN HEALTHCARE OF ELKINS LLC

Practice address

4252 Crossover
Fayettevillle, AR 72703-2936

Phone

(479) 310-8197

NPI assigned

Jun 6, 2013

Last updated

May 15, 2018By 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

Mrs. Karen C Reynolds, APNNPI 1063748101

Title

Owner/ Operator

Phone

(479) 530-5092

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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.

• Karen Christine Reynolds, FNP-BC

  • Family Nurse Practitioner
  • Fayetteville, AR
  • NPI 1063748101
  Authorized official Same address or phone

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

{
    "created_epoch": "1370476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1526342400000",
    "number": "1447698972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "847 KENSINGTON CV",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727626286",
            "telephone_number": "479-530-5092",
            "fax_number": "479-361-8009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4252 CROSSOVER",
            "city": "FAYETTEVILLLE",
            "state": "AR",
            "postal_code": "727032936",
            "telephone_number": "479-310-8197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOMETOWN HEALTHCARE OF ELKINS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-06",
        "last_updated": "2018-05-15",
        "status": "A",
        "authorized_official_last_name": "REYNOLDS",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER/ OPERATOR",
        "authorized_official_telephone_number": "479-530-5092",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "APN"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "AR",
            "license": "04D2045431",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "194826758",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.