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HOMETOWN OCCUPATIONAL MEDICINE
NPI 1609553965
General Practice in Bonare, GA

Active since June 29, 2023CLIA 11D2278749 · Waiver
89 SANDY RUN RD, SUITE 500, BONARE, GA 31005(478) 412-4774(478) 412-4775 Get Directions Write a Review

NPPES record last updated: June 29, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Hometown Occupational Medicine NPPES

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

HOMETOWN OCCUPATIONAL MEDICINE (NPI 1609553965) is a healthcare organization registered as a general practice in Bonare, Georgia and active in the NPI registry since June 2023. The organization holds a CLIA Waiver certificate valid through March 22, 2027 and lists Breanna Dorothy Bassett, Ceo/president, as its authorized official.

NPPES Registry Identity

NPI1609553965
Entity TypeOrganization
Primary Taxonomy208D00000X
Legal Business NameHOMETOWN OCCUPATIONAL MEDICINE
Location Address89 SANDY RUN RD, SUITE 500Bonare, GA 31005
Mailing Address89 Sandy Run Rd, Suite 500Bonare, GA 31005 · (478) 412-4774 · Fax (478) 412-4775
Phone(478) 412-4774
Fax(478) 412-4775
Organization SubpartNo
Authorized OfficialBreanna Dorothy BassettCeo/president · (478) 972-0403
Enumeration DateJune 29, 2023
NPPES CertifiedJune 29, 2023
✔ NPI 1609553965 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
Definition

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

89 SANDY RUN RD, Bonare, GA 31005
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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

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 11D2278749

Hometown Occupational Medicine, LLC · Bonaire, GA
Active · expires Mar 22, 2027
CLIA Number11D2278749
Laboratory TypeOccupational Med
Certificate Effective DateMarch 23, 2025
Certificate Expiration DateMarch 22, 2027
Laboratory DirectorBrian J. Ludwig
Laboratory Phone(478) 972-0403
Laboratory LocationHometown Occupational Medicine, LLC89 Sandy Run Road, Suite 500, Bonaire, GA 31005
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Occupational Medicine's NPI number?

The NPI number for Hometown Occupational Medicine is 1609553965. It was assigned to this organization in the NPPES registry on June 29, 2023.

Where is Hometown Occupational Medicine located?

Hometown Occupational Medicine is located at 89 Sandy Run Rd Suite 500, Bonare, GA 31005. The listed phone number is (478) 412-4774.

What is Hometown Occupational Medicine's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Does Hometown Occupational Medicine hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D2278749) is associated with this NPI, valid through March 22, 2027. 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 Occupational Medicine was last updated on June 29, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.