Hometown Family Medicine PS

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

HOMETOWN FAMILY MEDICINE PS

Practice address

210 W Main Ave
Ritzville, WA 99169-1410

Phone

(509) 659-4800

Fax

(509) 659-4801

NPI assigned

Feb 23, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Charles M Sackmann, MDNPI 1396759635

Title

MD-Owner

Phone

(509) 659-4800

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

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

CLIA laboratory certificates

Practitioners 3

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

• Charles Martin Sackmann, MD

  • Family Medicine Physician
  • Ritzville, WA
  • NPI 1396759635
  Medicare reassignment Care Compare group NPD Authorized official
• Lauren Elizabeth Phillips

  • Family Nurse Practitioner
  • Ritzville, WA
  • NPI 1396313920
  Medicare reassignment Care Compare group NPD
• Jacqueline Hines-Kruse, PA-C

  • Physician Assistant
  • Ritzville, WA
  • NPI 1316565708
  Medicare reassignment

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

{
    "created_epoch": "1298419200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1428883200000",
    "number": "1881991131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 438",
            "address_2": "210 W. MAIN",
            "city": "RITZVILLE",
            "state": "WA",
            "postal_code": "99169",
            "telephone_number": "509-659-4800",
            "fax_number": "509-659-4801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 W MAIN AVE",
            "city": "RITZVILLE",
            "state": "WA",
            "postal_code": "991691410",
            "telephone_number": "509-659-4800",
            "fax_number": "509-659-4801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOMETOWN FAMILY MEDICINE PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-23",
        "last_updated": "2015-04-13",
        "status": "A",
        "authorized_official_last_name": "SACKMANN",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MD-OWNER",
        "authorized_official_telephone_number": "509-659-4800",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yevette M Gossett, LMP
• Corrina Lea Gray, PHARM D
• Caylon W. Haggard, PA-C
• Douglas E. Hille, DDS
• Jacqueline Hines-Kruse, PA-C
• Abby Horak, ARNP
• Independent Pharmacist Relief Services
• Jane Elizabeth Ivy, BSN, RN
• Kennewick Pain Clinic Inc PS
• Dustin Killian, ATC, PTA

• Primary Care Clinic/Center in Ritzville, WA
• Providers in Ritzville, WA by specialty
• Primary Care Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2015; 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.