Individual provider Active NPI

Latoni Timesha Bethea, APRN

  • Family Nurse Practitioner
  • Columbia, SC
National Provider Identifier
1013552587
Registry record updated Oct 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
23615 Issued in SC
Practice address
111 Doctor Cir
Columbia, SC 29203-6502
Phone
(800) 491-0909
NPI assigned
Nov 8, 2019
Last updated
Oct 31, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 31, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 5012875 NC
Gerontology Nurse Practitioner 363LG0600X 23614 SC
Family Nurse Practitioner 363LF0000X 23615 SC Primary

Addresses

Primary practice location

111 Doctor Cir
Columbia, SC 29203-6502

Mailing address

111 Doctor Cir
Columbia, SC 29203-6502
Phone (800) 491-0909

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, NC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200401000714 SC Practitioner - Nurse Practitioner 3274962980 Reassigns benefits to 4 organizations
I20231010000426 NC Practitioner - Nurse Practitioner 3274962980 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
May accept Medicare assignment
Group practices
Ih Physician Services PCGroup PAC ID 5991165458, 56 clinicians
Moore Care Therapy and Psychology ClinicGroup PAC ID 5698161560, 4 clinicians

Practice addresses (Care Compare)

100 Pavilion Way
Suite E4 and E5
Southern Pines, NC 28387-4559
Phone (910) 684-5078

436 W Palmetto St
Suite D
Florence, SC 29501-4425
Phone (843) 799-0083

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
23614SCMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
SC House Calls Inc CurrentSince Mar 16, 2020 Accepting new patients
Rosalyn Cares Consulting LLC Family CurrentSince Feb 1, 2021 Accepting new patients
Ih Physician Services PC CurrentSince Aug 27, 2023 Accepting new patients
SC House Calls Inc CurrentSince Mar 16, 2020 Accepting new patients
Moore Care Therapy and Psychology Clinic CurrentSince Nov 17, 2021 Accepting new patients
Ih Physician Services, PC CurrentSince Aug 27, 2023 Accepting new patients
K and M Transportation Services LLC PastSince Nov 1, 2019 Accepting new patients

Locations

655 Brawley School Rd
Ste 200
Mooresville, NC 28117

100 Pavilion Way
Ste E4
Southern Pnes, NC 28387
Phone (910) 684-5078

111 Doctor Cir
Columbia, SC 29203
Phone (803) 730-8910

1624 Main St
Columbia, SC 29201
Phone (803) 454-0365

1801 W Evans St
Ste 107
Florence, SC 29501
Phone (888) 918-2415

1801 W Evans St
Ste D107
Florence, SC 29501
Phone (843) 495-8988

600 Senior Way
Florence, SC 29505
Phone (843) 799-1067

660 Senior Way
Florence, SC 29505

1053 Center St
West Columbia, SC 29169
Phone (803) 454-0365

Interoperability endpoints

  • Direct secure messaging: latoni.bethea.1@7602.direct.athenahealth.com

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1573171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667174400000",
    "number": "1013552587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 DOCTOR CIR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036502",
            "telephone_number": "800-491-0909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 DOCTOR CIR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036502",
            "telephone_number": "800-491-0909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BETHEA",
        "first_name": "LATONI",
        "middle_name": "TIMESHA",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-08",
        "last_updated": "2022-10-31",
        "certification_date": "2022-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NC",
            "license": "5012875",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "SC",
            "license": "23614",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "23615",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.