Individual provider Active NPI

Peter C Latkin, MD

  • Allergy Physician
  • Falls Church, VA
National Provider Identifier
1063522290
Registry record updated Mar 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy PhysicianTaxonomy code 207KA0200X
License
0101023974 Issued in VA
Practice address
6201 Leesburg Pike
#300
Falls Church, VA 22044
Phone
(703) 534-2445
Fax
(703) 538-5575
NPI assigned
Aug 30, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 4, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy Physician 207KA0200X 0101023974 VA Primary

Addresses

Primary practice location

6201 Leesburg Pike
#300
Falls Church, VA 22044

Mailing address

6201 Leesburg Pike
#300
Falls Church, VA 22044
Phone (703) 534-2445

Other identifiers 1

IdentifierTypeStateIssuer
6756166MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204588800000",
    "number": "1063522290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6201 LEESBURG PIKE",
            "address_2": "#300",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "22044",
            "telephone_number": "703-534-2445",
            "fax_number": "703-538-5575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6201 LEESBURG PIKE",
            "address_2": "#300",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "22044",
            "telephone_number": "703-534-2445",
            "fax_number": "703-538-5575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LATKIN",
        "first_name": "PETER",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2008-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207KA0200X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology, Allergy",
            "state": "VA",
            "license": "0101023974",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6756166",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Falls Church, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.