Healing Roots Family Practice LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

HEALING ROOTS FAMILY PRACTICE LLC

Practice address

111 N Pine St
Trenton, GA 30752-2503

Phone

(706) 657-4985

NPI assigned

Dec 16, 2021

Organization subpart

No

Name

Crystal Hancock, FNPNPI 1881019305

Title

Owner

Phone

(706) 657-4985

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Crystal L Hancock, NP

  • Family Nurse Practitioner
  • Trenton, GA
  • NPI 1881019305

  GA

  Medicare reassignment NPD Authorized official
• Paul E Ballinger, PA

  • Medical Physician Assistant
  • Chickamauga, GA
  • NPI 1881677847

  GA

  Medicare reassignment
• Wayne T Richey, MD

  • Family Medicine Physician
  • Trion, GA
  • NPI 1073508115

  Family Medicine

  NPD (past)

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

CLIA laboratory certificates

Medicare fee-for-service enrollment

Enrolled in GA

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 16, 2021.

{
    "created_epoch": "1639612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639612800000",
    "number": "1831858802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 N PINE ST",
            "city": "TRENTON",
            "state": "GA",
            "postal_code": "307522503",
            "telephone_number": "706-657-4985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 N PINE ST",
            "city": "TRENTON",
            "state": "GA",
            "postal_code": "307522503",
            "telephone_number": "706-657-4985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALING ROOTS FAMILY PRACTICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-16",
        "last_updated": "2021-12-16",
        "certification_date": "2021-12-16",
        "status": "A",
        "authorized_official_last_name": "HANCOCK",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "706-657-4985",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melody Clements Gaston, OTR L
• Georgia CVS Pharmacy LLC
• Amelia B Granberry, DMD
• Tyler A Hamilton, D.D.S.
• Crystal L Hancock, NP
• Highland Rivers Community Service Board
• Highland Rivers Community Service Board
• Lucinda S Hill, M.D.
• Anna Katharine Horne, LPC
• Idoc Holdings LLC

• All providers in Trenton, GA
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2021; 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.