HOMER L. STALEY, MD
NPI 1619103579
Family Medicine in Lawrenceburg, TN

Q: What is Lawrenceburg Family Practice Associates, PC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Active since June 05, 2009CLIA 44D0975649 · Waiver

104 N LOCUST AVE, LAWRENCEBURG, TN 38464(931) 762-6476(931) 762-1841 Get Directions Write a Review

NPPES record last updated: June 5, 2009. Verified against the NPPES registry weekly; last sync: November 01, 2026.

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About Homer L. Staley, Md NPPES

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

HOMER L. STALEY, MD (NPI 1619103579) is a healthcare organization registered as a family medicine in Lawrenceburg, Tennessee and active in the NPI registry since June 2009. The organization holds a CLIA Waiver certificate valid through October 22, 2028 and lists Homer L Staley, President, as its authorized official.

NPPES Registry Identity

NPI1619103579

Entity TypeOrganization

Primary Taxonomy207Q00000X

Legal Business NameLAWRENCEBURG FAMILY PRACTICE ASSOCIATES, PC

Location Address104 N LOCUST AVELawrenceburg, TN 38464-3734

Mailing Address104 N Locust AveLawrenceburg, TN 38464-3734 · (931) 762-6476 · Fax (931) 762-1841

Phone(931) 762-6476

Fax(931) 762-1841

Organization SubpartNo

Authorized OfficialHomer L StaleyPresident · (931) 762-6476

Enumeration DateJune 5, 2009

✔ NPI 1619103579 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in TN · MD008952

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Also ListedFamily Medicine · Geriatric MedicineTaxonomy 207QG0300X · License MD008952 (TN)

104 N LOCUST AVE, Lawrenceburg, TN 38464

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Other Names 1

Other NameHomer L. Staley, Md

Other Identifiers 3

Medicaid3170118TN

Medicare PIN1609886936

Medicare UPINB03386TN

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 MULTIPLE SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Homer L. Staley, Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Homer L. Staley, MD, which bills Medicare for the services this clinician delivers.

Clinician (1)

Homer Staley, M.D.

Family Practice

NPI 1609886936

104 N LOCUST AVE
Lawrenceburg, TN 38464

(931) 762-6476

✔ PECOS✔ Accepts Medicare0.1 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 Waiver 44D0975649

Lawrenceburg Family Practice Associates PC · Lawrenceburg, TN

Active · expires Oct 22, 2028

CLIA Number44D0975649

Laboratory TypePhysician Office

Certificate Effective DateOctober 23, 2026

Certificate Expiration DateOctober 22, 2028

Laboratory DirectorDr. Homer L. Staley

Laboratory Phone(931) 762-6476

Laboratory LocationLawrenceburg Family Practice Associates PC104 North Locust Avenue, Lawrenceburg, TN 38464

CLIA data matches this NPI record on: Address 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 Lawrenceburg Family Practice Associates, PC's NPI number?

The NPI number for Lawrenceburg Family Practice Associates, PC is 1619103579. It was assigned to this organization in the NPPES registry on June 5, 2009. The provider is also known as Homer L. Staley, MD.

Where is Lawrenceburg Family Practice Associates, PC located?

Lawrenceburg Family Practice Associates, PC is located at 104 N Locust Ave, Lawrenceburg, TN 38464. The listed phone number is (931) 762-6476.

What is Lawrenceburg Family Practice Associates, PC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Lawrenceburg Family Practice Associates, PC enrolled in Medicare?

Yes. Lawrenceburg Family Practice Associates, PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Lawrenceburg Family Practice Associates, PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Family Practice) reassigns their Medicare billing to Lawrenceburg Family Practice Associates, PC. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Lawrenceburg Family Practice Associates, PC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 44D0975649) is associated with this NPI, valid through October 22, 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 Lawrenceburg Family Practice Associates, PC was last updated on June 5, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.