Hometown Urgent Care and Family Medicine

Primary specialty

Urgent Care Clinic/CenterTaxonomy code 261QU0200X

Legal business name

HOMETOWN URGENT CARE AND FAMILY MEDICINE

Practice address

209 Main St
Union, MS 39365-2521

Phone

(601) 504-3424

NPI assigned

Sep 7, 2022

Last updated

Sep 7, 2022By 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

Phillip Miller, APRNNPI 1497124762

Title

Owner

Phone

(601) 504-3424

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS2 enrollments

Enrollment records 2

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1598486755. Details of each certification follow.

• CCN A53843 Rural health clinic · Active · Details

Rural health clinic certification: CCN A53843

Legal name

HOMETOWN URGENT CARE AND FAMILY MEDICINE

Certification status

Active

Provider type (POS)

Rural health clinic

Participating since

Aug 20, 2024

Last certification

Aug 20, 2024

Ownership / control type

1C

Organization structure

PartnershipProprietary

Enrollment address

209 Main St
Union, MS 39365-2521

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

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 3

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Jacob Cox, DO

  • Family Medicine Physician
  • Tupelo, MS
  • NPI 1861922155

  5% Or Greater Direct Ownership Interest

  CMS ownership
• Phillip A Miller, FNP

  • Family Nurse Practitioner
  • New Iberia, LA
  • NPI 1497124762

  5% Or Greater Direct Ownership Interest

  CMS ownership

Practitioners 5

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.

• Phillip A Miller, FNP

  • Family Nurse Practitioner
  • New Iberia, LA
  • NPI 1497124762

  MS

  Medicare reassignment Care Compare group NPD Authorized official
• Jamie Agent, NP-C

  • Family Nurse Practitioner
  • Meridian, MS
  • NPI 1245889807
  Medicare reassignment Care Compare group NPD
• Jerica Shea Hazelwood, FNP-BC

  • Family Nurse Practitioner
  • Union, MS
  • NPI 1740023688
  Medicare reassignment Care Compare group NPD
• Glenda R. Barrett, FNP

  • Family Nurse Practitioner
  • Union, MS
  • NPI 1518949262
  Medicare reassignment NPD
• Jacob Cox, DO

  • Family Medicine Physician
  • Tupelo, MS
  • NPI 1861922155
  Medicare reassignment NPD

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

{
    "created_epoch": "1662508800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662508800000",
    "number": "1598486755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10080 ROAD 539",
            "city": "PHILADELPHIA",
            "state": "MS",
            "postal_code": "393508086",
            "telephone_number": "601-504-3424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 MAIN ST",
            "city": "UNION",
            "state": "MS",
            "postal_code": "393652521",
            "telephone_number": "601-504-3424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOMETOWN URGENT CARE AND FAMILY MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-07",
        "last_updated": "2022-09-07",
        "certification_date": "2022-09-07",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "PHILLIP",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-504-3424",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jerica Shea Hazelwood, FNP-BC
• Wendy Hendricks, LPTA
• Angela Henry
• Deborah A Hester, MD
• Hilltop Mississippi Healthcare LLC (Hilltop Manor Health and Rehabilitation Center)
• Hospice Direct, Inc.
• Cole Harrison Hurst, PT, DPT
• Lindy Carol Jordan, RD LD
• Wendy Beeland Kirkland
• L. B. Adkins, O.D

• Urgent Care Clinic/Center in Union, MS
• Providers in Union, MS by specialty
• Urgent Care Clinic/Center in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.