NPIMap

Individual provider Active NPI

Carlos Alberto Latorre, M.D.

  • Family Medicine Physician
  • Vicksburg, MS
National Provider Identifier
1104088152
Registry record updated Nov 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
21672 Issued in MS
Practice address
1901 Mission 66
Vicksburg, MS 39180-3711
Phone
(601) 636-0097
NPI assigned
Jul 1, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 21672 MS Primary

Addresses

Primary practice location

1901 Mission 66
Vicksburg, MS 39180-3711

Mailing address

1901 Mission 66
Vicksburg, MS 39180-3711
Phone (601) 636-1173

Other practice location 1

1907 Mission 66
Vicksburg, MS 39180-3711
Phone (601) 636-1173

Other practice location 2

1101 S 28th Ave
Hattiesburg, MS 39402-2610
Phone (601) 296-2990

Other identifiers 1

IdentifierTypeStateIssuer
00003502MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110914000463 MS Practitioner - Family Practice 1456522911 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hattiesburg Clinic PAGroup PAC ID 5193706794, 525 clinicians

Practice addresses (Care Compare)

415 S 28TH Ave
Hattiesburg, MS 39401-7246
Phone (601) 264-6000

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Christina Hossley Inc Current Accepting new patients
Robert M Cannon MD LLC Current Accepting new patients
Flowers Medical Group LLC Family Medicine Current Accepting new patients
Joseph L Wilson MD Inc Current Accepting new patients
Robert C Masterson DO PA Inc Family Medicine Current Accepting new patients
Mission Primary Care Clinic PLLC Family Medicine Current Accepting new patients
Rlgmdpa Inc Family Medicine Current Accepting new patients
K McDaniel Inc Current Accepting new patients
Susan a Chiarito MD PA Inc Family Medicine Current Accepting new patients
Denesia Y Giffin PLLC Current Accepting new patients
J Russell Barnes MD PC Family Medicine Current Accepting new patients
BC Medical LLC Family Medicine Current Accepting new patients
Hattiesburg Clinic, PA Past Accepting new patients
State of Mississippi - University of Mississippi Medical Center Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: clatorre52483@directpatientrecord.com

Organizations & group practices 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1214870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730678400000",
    "number": "1104088152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 MISSION 66",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391803711",
            "telephone_number": "601-636-1173",
            "fax_number": "601-638-8287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 MISSION 66",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391803711",
            "telephone_number": "601-636-0097"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1907 Mission 66",
            "address_purpose": "LOCATION",
            "city": "Vicksburg",
            "state": "MS",
            "postal_code": "391803711",
            "country_code": "US",
            "telephone_number": "601-636-1173",
            "fax_number": "601-638-8287",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1101 S 28th Ave",
            "address_purpose": "LOCATION",
            "city": "Hattiesburg",
            "state": "MS",
            "postal_code": "394022610",
            "country_code": "US",
            "telephone_number": "601-296-2990",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LATORRE",
        "first_name": "CARLOS",
        "middle_name": "ALBERTO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-01",
        "last_updated": "2024-11-04",
        "certification_date": "2024-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "21672",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00003502",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vicksburg, MS

Sources for this page

Verify at the official NPI Registry.