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HOMETOWN PEDIATRICS LLC
NPI 1013623263
Clinic/Center - Medical Specialty in Vienna, GA

Active since January 30, 2023CLIA Certified · 2 labs
108 N 4TH ST, VIENNA, GA 31092(229) 231-5008(229) 231-5539 Get Directions Write a Review

NPPES record last updated: January 30, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Hometown Pediatrics Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

HOMETOWN PEDIATRICS LLC (NPI 1013623263) is a healthcare organization registered as a medical specialty in Vienna, Georgia and active in the NPI registry since January 2023. The organization holds 2 active CLIA laboratory certificates and lists Haley Ellis Pullen, Owner, as its authorized official.

NPPES Registry Identity

NPI1013623263
Entity TypeOrganization
Primary Taxonomy261QM2500X
Legal Business NameHOMETOWN PEDIATRICS LLC
Location Address108 N 4TH STVienna, GA 31092-1115
Mailing Address108 N 4th StVienna, GA 31092-1115
Phone(229) 231-5008
Fax(229) 231-5539
Organization SubpartNo
Authorized OfficialHaley Ellis PullenOwner · (850) 688-0943
Enumeration DateJanuary 30, 2023
NPPES CertifiedJanuary 30, 2023
✔ NPI 1013623263 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Medical SpecialtyAmbulatory Health Care Facilities
Taxonomy Code261QM2500X
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).
108 N 4TH ST, Vienna, GA 31092
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Other Identifiers 1

Medicaid1932748894GA

CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 11D2276167

Hometown Pediatrics LLC · Vienna, GA
Active · expires Feb 2, 2027
CLIA Number11D2276167
Laboratory TypePhysician Office
Certificate Effective DateFebruary 3, 2025
Certificate Expiration DateFebruary 2, 2027
Laboratory DirectorHaley E. Pullen
Laboratory Phone(229) 231-5008
Laboratory LocationHometown Pediatrics LLC108 N 4th Street, Vienna, GA 31092
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 11D2336498

Hometown Pediatrics · Perry, GA
Active · expires Jan 5, 2028
CLIA Number11D2336498
Laboratory TypePhysician Office
Certificate Effective DateJanuary 6, 2026
Certificate Expiration DateJanuary 5, 2028
Laboratory DirectorHaley E. Pullen
Laboratory Phone(229) 231-5008
Laboratory LocationHometown Pediatrics1365 Sam Nunn Blvd, Suite D, Perry, GA 31069
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

EMILY MICHELE TURNER FNP
Nurse Practitioner (Family)
108 N 4TH ST
VIENNA, GA 31092
Dooly County (229) 231-5008
HALEY ELLIS PULLEN
Nurse Practitioner (Family)
108 N 4TH ST
VIENNA, GA 31092
Dooly County (229) 231-5008

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Hometown Pediatrics LLC's NPI number?

The NPI number for Hometown Pediatrics LLC is 1013623263. It was assigned to this organization in the NPPES registry on January 30, 2023.

Where is Hometown Pediatrics LLC located?

Hometown Pediatrics LLC is located at 108 N 4th St, Vienna, GA 31092. The listed phone number is (229) 231-5008.

What is Hometown Pediatrics LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Medical Specialty, with taxonomy code 261QM2500X.

Does Hometown Pediatrics LLC hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Hometown Pediatrics LLC was last updated on January 30, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.