HOMETOWN HEALTHCARE OF PORT JERVIS
NPI 1477399871
Nurse Practitioner - Family in Port Jervis, NY
About Hometown Healthcare Of Port Jervis NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
HOMETOWN HEALTHCARE OF PORT JERVIS (NPI 1477399871) is a healthcare organization registered as a family in Port Jervis, New York and active in the NPI registry since July 2024. The organization holds a CLIA Waiver certificate valid through July 8, 2028 and lists Roselle Aguila Little, Managing Director, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Group Practice 1
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 Waiver 33D2307403
Hometown Healthcare Of Port Jervis, LLC · Port Jervis, NYOther Providers at the Same Location NPPES 2
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Healthcare Port Jervis Family Health Nurse Practitioner PLLC's NPI number?
The NPI number for Hometown Healthcare Port Jervis Family Health Nurse Practitioner PLLC is 1477399871. It was assigned to this organization in the NPPES registry on July 4, 2024. The provider is doing business as Hometown Healthcare Of Port Jervis.
Where is Hometown Healthcare Port Jervis Family Health Nurse Practitioner PLLC located?
Hometown Healthcare Port Jervis Family Health Nurse Practitioner PLLC is located at 32 Ball St, Port Jervis, NY 12771. The listed phone number is (845) 204-8204.
What is Hometown Healthcare Port Jervis Family Health Nurse Practitioner PLLC's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Does Hometown Healthcare Port Jervis Family Health Nurse Practitioner PLLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 33D2307403) is associated with this NPI, valid through July 8, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Hometown Healthcare Port Jervis Family Health Nurse Practitioner PLLC was last updated on November 19, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 months 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.
# Hometown Healthcare Of Port Jervis · NPI 1477399871
Family organization in Port Jervis, New York. Organization record, active in the CMS NPPES registry since July 4, 2024.
## Identity
- **NPI:** 1477399871 (Entity type: Organization)
- **Enumerated:** July 4, 2024
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **Legal business name:** Hometown Healthcare Port Jervis Family Health Nurse Practitioner Pllc
- **Organization subpart:** No
- **Authorized official:** Roselle Little, MANAGING DIRECTOR
## Practice location
- **Address:** 32 BALL ST, Port Jervis, NY 12771-2404
- **Phone:** (845) 204-8204 · **Fax:** (918) 398-9354
## Record status
- **NPPES last updated:** November 19, 2024
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1477399871) · Data from the CMS NPPES public registry.