Hometown Pediatrics, LLC
Organization Active NPI Pediatric Nurse Practitioner · Delphos, OH
NPI 1992447502 · NPPES record last updated Apr 3, 2023
Key facts
- NPI
- 1992447502
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pediatric Nurse Practitioner 363LP0200X
- Legal business name
- HOMETOWN PEDIATRICS, LLC
- Practice address
- 152 W 2ND St
Delphos, OH 45833-1601 - Phone
- (567) 765-1111
- Fax
- (833) 940-3627
- NPI assigned
- Apr 13, 2022
- Organization subpart
- No
Authorized official
- Name
- Thresa L Grothaus, APRN
- Title
- CPNP
- Phone
- (419) 236-3434
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 36D2253272 | Hometown Pediatrics, LLC | Certificate of waiver | Feb 17, 2028 |
National Provider Directory
Interoperability endpoints
- https://api.platform.athenahealth.com/25982/brand/1/csg/1/fhir/r4
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner |
363LP0200X | Yes |
Addresses
Primary practice location
152 W 2ND St
Delphos, OH 45833-1601
Mailing address
308 Taft St
Columbus Grove, OH 45830-1122
Phone (419) 236-3434
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0133929 | Medicaid | OH |
Other providers in Delphos, OH
- Shannon Hanus
- Healing Hope Consulting LCC
- Rhonda Henderson-Laidlaw
- Cassandra Hermiller
- Brenda Hoersten
- Judy K Huebner
- Patricia Hull
- Perry Monroe Hux
- Shawn Daniel Kill
- Krystin King
All providers in Delphos, OH · Pediatric Nurse Practitioner in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 3, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.