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HOMETOWN CARE OF MANTACHIE LLC
NPI 1164987426
Nurse Practitioner - Family in Mantachie, MS

Active since January 31, 2019CLIA 25D2162109 · Certificate of Compliance
3275 HIGHWAY 371 N, MANTACHIE, MS 38855(662) 282-7555 Get Directions Write a Review

NPPES record last updated: August 14, 2019. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Aug 14, 2019, Jan 31, 2019 (2 updates tracked since 2019).

About Hometown Care Of Mantachie Llc NPPES

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

HOMETOWN CARE OF MANTACHIE LLC (NPI 1164987426) is a healthcare organization registered as a family in Mantachie, Mississippi and active in the NPI registry since January 2019. The organization holds a CLIA Certificate of Compliance certificate valid through October 7, 2027 and lists Andrea Carpenter, Owner, as its authorized official.

NPPES Registry Identity

NPI1164987426
Entity TypeOrganization
Primary Taxonomy363LF0000X
Legal Business NameHOMETOWN CARE OF MANTACHIE LLC
Location Address3275 HIGHWAY 371 NMantachie, MS 38855-7145
Mailing Address3275 Hwy. 371, P.o. Box 418Mantachie, MS 38855-0418 · (662) 282-7555
Phone(662) 282-7555
Organization SubpartNo
Authorized OfficialAndrea CarpenterOwner · (662) 282-7555
Enumeration DateJanuary 31, 2019
Last NPPES UpdateAugust 14, 20192 updates tracked since enumeration
✔ NPI 1164987426 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
3275 HIGHWAY 371 N, Mantachie, MS 38855
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Hometown Care Of Mantachie Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

7

Medicare enrollment records show 7 clinicians reassign Medicare billing to Hometown Care Of Mantachie LLC, which bills Medicare for the services they deliver. Of these, 6 practice at this address and 7 within 10 miles. They are listed nearest first.

Clinicians, nearest first (7)

Andrea Carpenter, FNP-C
Nurse Practitioner
NPI 1780169557
3275 HIGHWAY 371 N
Mantachie, MS 38855
(662) 282-7555
✔ PECOS✔ Accepts MedicareSame address
Nativel Collins, CFNP
Nurse Practitioner
NPI 1437162690
3275 HIGHWAY 371 N
Mantachie, MS 38855
(662) 282-7555
✔ PECOS✔ Accepts MedicareSame address
Katherine Jones, FNP-BC
Nurse Practitioner
NPI 1851029409
3275 HIGHWAY 371 N
Mantachie, MS 38855
(662) 282-7555
✔ PECOS✔ Accepts MedicareSame address
Susan Newell
Nurse Practitioner
NPI 1376107409
3275 HIGHWAY 371 N
Mantachie, MS 38855
(662) 282-7555
✔ PECOS✔ Accepts MedicareSame address
Kristi Smith, MSN, FNP-C
Nurse Practitioner
NPI 1851876627
3275 HIGHWAY 371 N
Mantachie, MS 38855
(662) 282-7555
✔ PECOS✔ Accepts MedicareSame address
Hannah Boren, FNP-C
Nurse Practitioner
NPI 1831960574
3275 HIGHWAY 371 N
Mantachie, MS 38855
(662) 282-7555
✔ PECOS✔ Accepts MedicareSame address
Kimberly Stanley, FNP
Nurse Practitioner
NPI 1770824955
285 IVIE LN
Mantachie, MS 38855
(662) 282-4197
✔ PECOS✔ Accepts Medicare0.2 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

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 Compliance 25D2162109

Hometown Care Of Mantachie · Mantachie, MS
Active · expires Oct 7, 2027
CLIA Number25D2162109
Laboratory TypePractitioner Other
Certificate Effective DateOctober 8, 2025
Certificate Expiration DateOctober 7, 2027
Laboratory DirectorMr. Bryan Jackson
Laboratory Phone(662) 282-7555
Laboratory LocationHometown Care Of Mantachie3275 Highway 371 N, Mantachie, MS 38855
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

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 Care Of Mantachie LLC's NPI number?

The NPI number for Hometown Care Of Mantachie LLC is 1164987426. It was assigned to this organization in the NPPES registry on January 31, 2019.

Where is Hometown Care Of Mantachie LLC located?

Hometown Care Of Mantachie LLC is located at 3275 Highway 371 N, Mantachie, MS 38855. The listed phone number is (662) 282-7555.

What is Hometown Care Of Mantachie LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Hometown Care Of Mantachie LLC enrolled in Medicare?

Yes. Hometown Care Of Mantachie LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Hometown Care Of Mantachie LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 7 clinicians, all in Nurse Practitioner, reassign their Medicare billing to Hometown Care Of Mantachie LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 6 practice at this address and 7 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Hometown Care Of Mantachie LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 25D2162109) is associated with this NPI, valid through October 7, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Hometown Care Of Mantachie LLC accept?

Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter of Alabama and Ambetter of Tennessee and 1 other insurer list Hometown Care Of Mantachie LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Hometown Care Of Mantachie LLC was last updated on August 14, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.