Active NPI
Hometown Healthcare PC
- Family Medicine Physician
- Decatur, IN
National Provider Identifier
1558409698
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 01045263A
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 01045263A | IN | Primary |
| Nurse Practitioner | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000105448 | Other | IN | ANTHEM |
| 20274870A | Medicaid | IN | |
| 9132 | Other | IN | PHP |
| 080154120 | Other | IN | RAILROAD MEDICARE |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Medicine Physician
- Decatur, IN
- NPI 1700866183
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.