Active NPI
David Scott Lattos, R.PH.
- Pharmacist
- West Salem, WI
National Provider Identifier
1104909464
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 12711
- Practice address
- 550 Driftwood St
West Salem, WI 54669-2200 - Phone
- (608) 786-9030
- Fax
- (866) 764-4884
- NPI assigned
- Oct 23, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 12711 | WI | Primary |
Addresses
Primary practice location
550 Driftwood St
West Salem, WI 54669-2200
Mailing address
550 Driftwood St
West Salem, WI 54669-2200
Phone (608) 786-9030
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 12711 | Other | WI | WISCONSIN DEPT OF REG |
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)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12711 | WI | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161561600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1187049600000",
"number": "1104909464",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "550 DRIFTWOOD ST",
"city": "WEST SALEM",
"state": "WI",
"postal_code": "546692200",
"telephone_number": "608-786-9030",
"fax_number": "866-764-4884"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "550 DRIFTWOOD ST",
"city": "WEST SALEM",
"state": "WI",
"postal_code": "546692200",
"telephone_number": "608-786-9030",
"fax_number": "866-764-4884"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LATTOS",
"first_name": "DAVID",
"middle_name": "SCOTT",
"name_prefix": "Mr.",
"credential": "R.PH.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-23",
"last_updated": "2007-08-14",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WI",
"license": "12711",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WISCONSIN DEPT OF REG",
"identifier": "12711",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in West Salem, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.