Hometown Occupational Medicine

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

HOMETOWN OCCUPATIONAL MEDICINE

Practice address

89 Sandy Run Rd
Suite 500
Bonare, GA 31005

Phone

(478) 412-4774

Fax

(478) 412-4775

NPI assigned

Jun 29, 2023

Last updated

Jun 29, 2023By 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. Breanna Dorothy Bassett

Title

Ceo/President

Phone

(478) 972-0403

Specialties & licenses 1

Addresses

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

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

{
    "created_epoch": "1687996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687996800000",
    "number": "1609553965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "89 SANDY RUN RD",
            "address_2": "SUITE 500",
            "city": "BONARE",
            "state": "GA",
            "postal_code": "31005",
            "telephone_number": "478-412-4774",
            "fax_number": "478-412-4775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "89 SANDY RUN RD",
            "address_2": "SUITE 500",
            "city": "BONARE",
            "state": "GA",
            "postal_code": "31005",
            "telephone_number": "478-412-4774",
            "fax_number": "478-412-4775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOMETOWN OCCUPATIONAL MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-29",
        "last_updated": "2023-06-29",
        "certification_date": "2023-06-29",
        "status": "A",
        "authorized_official_last_name": "BASSETT",
        "authorized_official_first_name": "BREANNA",
        "authorized_official_middle_name": "DOROTHY",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "478-972-0403",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.