Active NPI
Patrick Dean Homer
- Funeral Director
- Dushore, PA
National Provider Identifier
1689120610
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Funeral Director
- License
- 011975-L
- Practice address
- 206 Water Street
Dushore, PA 18614-0001 - Phone
- (570) 928-8163
- Fax
- (570) 928-8116
- NPI assigned
- Aug 30, 2016
- Last updated
- Aug 30, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Funeral Director | 176P00000X | 011975-L | PA | Primary |
Addresses
Primary practice location
206 Water Street
Dushore, PA 18614-0001
Mailing address
PO Box 1
206 Water St
Dushore, PA 18614-0001
Phone (570) 928-8163
Other names 1
- P Dean Homer
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 011975-L | PA | MD | Funeral Director |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1472515200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1472515200000",
"number": "1689120610",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1",
"address_2": "206 WATER ST",
"city": "DUSHORE",
"state": "PA",
"postal_code": "186140001",
"telephone_number": "570-928-8163",
"fax_number": "570-928-8116"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "206 WATER STREET",
"city": "DUSHORE",
"state": "PA",
"postal_code": "186140001",
"telephone_number": "570-928-8163",
"fax_number": "570-928-8116"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOMER",
"first_name": "PATRICK",
"middle_name": "DEAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-08-30",
"last_updated": "2016-08-30",
"status": "A"
},
"taxonomies": [
{
"code": "176P00000X",
"taxonomy_group": "",
"desc": "Funeral Director",
"state": "PA",
"license": "011975-L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "P DEAN",
"last_name": "HOMER",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Dushore, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.