Organization Active NPI

Hometown Healthcare PC

  • Family Medicine Physician
  • Decatur, IN
National Provider Identifier
1558409698
Registry record updated Nov 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01045263A Issued in IN
Legal business name
HOMETOWN HEALTHCARE PC
Practice address
955 High St
Ste 2
Decatur, IN 46733-2326
Phone
(260) 724-8700
Fax
(260) 728-3821
NPI assigned
Feb 1, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2009

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

Authorized official

Name
Michael E Ainsworth, MD
Title
Sole Proprietor
Phone
(206) 724-8700

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 01045263A IN Primary
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X 71001926A IN

Addresses

Primary practice location

955 High St
Ste 2
Decatur, IN 46733-2326

Mailing address

955 High St
Ste 2
Decatur, IN 46733-2326
Phone (260) 724-8700

Other identifiers 4

IdentifierTypeStateIssuer
000000105448OtherINANTHEM
20274870AMedicaidIN
9132OtherINPHP
080154120OtherINRAILROAD MEDICARE

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1258588800000",
    "number": "1558409698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "955 HIGH ST",
            "address_2": "STE 2",
            "city": "DECATUR",
            "state": "IN",
            "postal_code": "467332326",
            "telephone_number": "260-724-8700",
            "fax_number": "260-728-3821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "955 HIGH ST",
            "address_2": "STE 2",
            "city": "DECATUR",
            "state": "IN",
            "postal_code": "467332326",
            "telephone_number": "260-724-8700",
            "fax_number": "260-728-3821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOMETOWN HEALTHCARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-01",
        "last_updated": "2009-11-19",
        "status": "A",
        "authorized_official_last_name": "AINSWORTH",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "SOLE PROPRIETOR",
        "authorized_official_telephone_number": "206-724-8700",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01045263A",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71001926A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000105448",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20274870A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHP",
            "identifier": "9132",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "080154120",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2009; 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.