Active NPI
Homegrown Essential Pediatrics
- Primary Care Nurse Practitioner
- Smithtown, NY
National Provider Identifier
1700636164
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Care Nurse Practitioner
- Legal business name
- HOMEGROWN ESSENTIAL PEDIATRICS
- Practice address
- 267 E Main St BLDG C
Smithtown, NY 11787-2847 - Phone
- (631) 248-2700
- Fax
- (866) 456-0906
- NPI assigned
- Mar 26, 2024
- 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
- Heather Ann Riddle, DNP
- Title
- DNP
- Phone
- (631) 248-2700
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Nurse Practitioner | 363LP2300X | Primary |
Addresses
Primary practice location
267 E Main St BLDG C
Smithtown, NY 11787-2847
Mailing address
267 E Main St BLDG C
Smithtown, NY 11787-2847
Phone (631) 248-2700
Other names 1
- Homegrown Essential Wellness Pediatrics & Family
National Provider Directory
National Provider DirectoryLocations
257 E Main St
Ste B
Smithtown, NY 11787
Phone (631) 248-2700
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Pediatric Nurse Practitioner
- Smithtown, NY
- NPI 1295955508
-
- Family Nurse Practitioner
- Smithtown, NY
- NPI 1912734898
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1711411200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1785974400000",
"number": "1700636164",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "267 E MAIN ST BLDG C",
"city": "SMITHTOWN",
"state": "NY",
"postal_code": "117872847",
"telephone_number": "631-248-2700",
"fax_number": "866-456-0906"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "267 E MAIN ST BLDG C",
"city": "SMITHTOWN",
"state": "NY",
"postal_code": "117872847",
"telephone_number": "631-248-2700",
"fax_number": "866-456-0906"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HOMEGROWN ESSENTIAL PEDIATRICS",
"organizational_subpart": "NO",
"enumeration_date": "2024-03-26",
"last_updated": "2026-08-06",
"certification_date": "2026-08-06",
"status": "A",
"authorized_official_last_name": "RIDDLE",
"authorized_official_first_name": "HEATHER",
"authorized_official_middle_name": "ANN",
"authorized_official_title_or_position": "DNP",
"authorized_official_telephone_number": "631-248-2700",
"authorized_official_credential": "DNP"
},
"taxonomies": [
{
"code": "363LP2300X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner, Primary Care",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Homegrown Essential Wellness Pediatrics & Family",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Homegrown Essential Wellness Pediatrics & Family",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Smithtown, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.