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HOMETOWN HEALTHCARE OF BYRON LLC
NPI 1699430660
Nurse Practitioner - Family in Byron, GA

Active since November 04, 2021CLIA 11D2244760 · Waiver
103 MOSELEY RD, BYRON, GA 31008(478) 654-5327(478) 654-5218 Get Directions Write a Review

NPPES record last updated: November 12, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Nov 12, 2021, Nov 4, 2021 (2 updates tracked since 2021).

About Hometown Healthcare Of Byron Llc NPPES

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

HOMETOWN HEALTHCARE OF BYRON LLC (NPI 1699430660) is a healthcare organization registered as a family in Byron, Georgia and active in the NPI registry since November 2021. The organization holds a CLIA Waiver certificate valid through December 5, 2027 and lists Haley Pulliam, Member, as its authorized official.

NPPES Registry Identity

NPI1699430660
Entity TypeOrganization
Primary Taxonomy363LF0000X
Legal Business NameHOMETOWN HEALTHCARE OF BYRON LLC
Location Address103 MOSELEY RDByron, GA 31008-7148
Mailing AddressPo Box 2247Byron, GA 31008-2247 · (478) 654-5327 · Fax (478) 654-5218
Phone(478) 654-5327
Fax(478) 654-5218
Organization SubpartNo
Authorized OfficialHaley PulliamMember · (478) 654-5327
Enumeration DateNovember 4, 2021
Last NPPES UpdateNovember 12, 20212 updates tracked since enumeration
NPPES CertifiedNovember 12, 2021
✔ NPI 1699430660 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
Also ListedFamily MedicineTaxonomy 207Q00000X
Also ListedNurse Practitioner · Primary CareTaxonomy 363LP2300X
103 MOSELEY RD, Byron, GA 31008
Open in Google Maps ↗

Group Practice 2

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP
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 Absolute Total Care, Ambetter Health, Ambetter of Alabama and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

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

Medicare Revalidation Due Date

Revalidation due by November 30, 2026

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateGeorgiaEnrollment IDO20211123001642Non-DME Part B · Clinic/Group PracticeDue dateNovember 30, 2026
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Hometown Healthcare Of Byron LLC, which bills Medicare for the services they deliver. Of these, 1 practice within 10 miles. They are listed nearest first.

Clinicians, nearest first (2)

Jennifer Smith
Nurse Practitioner
NPI 1023408291
110 JAILHOUSE ALY
Byron, GA 31008
(478) 654-5327
✔ PECOS✔ Accepts Medicare0.1 mi
Raymond Root, FNP-C
Nurse Practitioner
NPI 1366290843
5791 ZEBULON RD STE A
Macon, GA 31210
(478) 787-0410
✔ PECOS✔ Accepts Medicare16 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 11D2244760

Hometown Healthcare Of Byron, LLC · Byron, GA
Active · expires Dec 5, 2027
CLIA Number11D2244760
Laboratory TypePractitioner Other
Certificate Effective DateDecember 6, 2025
Certificate Expiration DateDecember 5, 2027
Laboratory DirectorJennifer Smith
Laboratory Phone(478) 654-5327
Laboratory LocationHometown Healthcare Of Byron, LLC110 Jailhouse Aly, Byron, GA 31008
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 Healthcare Of Byron LLC's NPI number?

The NPI number for Hometown Healthcare Of Byron LLC is 1699430660. It was assigned to this organization in the NPPES registry on November 4, 2021.

Where is Hometown Healthcare Of Byron LLC located?

Hometown Healthcare Of Byron LLC is located at 103 Moseley Rd, Byron, GA 31008. The listed phone number is (478) 654-5327.

What is Hometown Healthcare Of Byron LLC's specialty?

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

Is Hometown Healthcare Of Byron LLC enrolled in Medicare?

Yes. Hometown Healthcare Of Byron LLC is registered in the Medicare PECOS enrollment system.

When is Hometown Healthcare Of Byron LLC's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Georgia, Clinic/Group Practice) is due for revalidation by November 30, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

How many clinicians bill Medicare through Hometown Healthcare Of Byron LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Nurse Practitioner, reassign their Medicare billing to Hometown Healthcare Of Byron 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, 1 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Hometown Healthcare Of Byron LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D2244760) is associated with this NPI, valid through December 5, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Hometown Healthcare Of Byron LLC accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee list Hometown Healthcare Of Byron 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 Healthcare Of Byron LLC was last updated on November 12, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.