Organization Active NPI

Hometown Doc, PA

  • Family Medicine Physician
  • Harrison, AR
National Provider Identifier
1568941433
Registry record updated Jul 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
C7305 Issued in AR
Legal business name
HOMETOWN DOC, PA
Practice address
1014 N Spring St
Harrison, AR 72601-2918
Phone
(870) 399-0077
Fax
(833) 607-6390
NPI assigned
Aug 10, 2018
Last updated
Jul 23, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2020

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

Authorized official

Name
Dr. Thomas A. Langston, MDNPI 1720086952
Title
President/Incorporator
Phone
(870) 399-0077

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X C7305 AR Primary

Addresses

Primary practice location

1014 N Spring St
Harrison, AR 72601-2918

Mailing address

1014 N Spring St
Harrison, AR 72601-2918
Phone (870) 399-0077

Other identifiers 1

IdentifierTypeStateIssuer
113835001MedicaidAR

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181120000699 AR Part B Supplier - Clinic/Group Practice 9335493808 Receives reassigned benefits from 1 practitioner
Practice locations: Harrison, AR

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.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
04D2161026Hometown Doc, PA1014 N Spring St, Harrison, AR 72601Certificate of waiverJan 23, 2027

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, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1533859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595462400000",
    "number": "1568941433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1014 N SPRING ST",
            "city": "HARRISON",
            "state": "AR",
            "postal_code": "726012918",
            "telephone_number": "870-399-0077",
            "fax_number": "833-607-6390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1014 N SPRING ST",
            "city": "HARRISON",
            "state": "AR",
            "postal_code": "726012918",
            "telephone_number": "870-399-0077",
            "fax_number": "833-607-6390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOMETOWN DOC, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-10",
        "last_updated": "2020-07-23",
        "certification_date": "2020-07-23",
        "status": "A",
        "authorized_official_last_name": "LANGSTON",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PRESIDENT/INCORPORATOR",
        "authorized_official_telephone_number": "870-399-0077",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "C7305",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "113835001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrison, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2020; 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.