Individual provider Active NPI

Larry J Latour, O.D. P.A.

  • Optometrist
  • Alachua, FL
National Provider Identifier
1114191012
Registry record updated Apr 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC1543 Issued in FL
Practice address
15551 NW US Highway 441 Unit 110
Alachua, FL 32615-9330
Phone
(386) 462-7772
Fax
(386) 462-1122
NPI assigned
Apr 22, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 22, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC1543 FL Primary

Addresses

Primary practice location

15551 NW US Highway 441 Unit 110
Alachua, FL 32615-9330

Mailing address

15551 NW US Highway 441 Unit 110
Alachua, FL 32615-9330
Phone (386) 462-7772

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120202000111 FL Practitioner - Optometry 3173718285 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

15551 NW US
Suite 110
Alachua, FL 32615
Phone (386) 462-7772

15551 NW US Hwy 441
Unit 110
Alachua, FL 32615-9330

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC1543FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Larry J Latour OD PA Optometrist CurrentSince Dec 7, 2011 Accepting new patients
Family Health Center of Columbia County, Inc. PastSince Oct 21, 2010 Accepting new patients

Locations

15551 NW US Highway 441
Unit 110
Alachua, FL 32615
Phone (386) 462-7772

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1208822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208822400000",
    "number": "1114191012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15551 NW US HIGHWAY 441 UNIT 110",
            "city": "ALACHUA",
            "state": "FL",
            "postal_code": "326159330",
            "telephone_number": "386-462-7772",
            "fax_number": "386-462-1122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15551 NW US HIGHWAY 441 UNIT 110",
            "city": "ALACHUA",
            "state": "FL",
            "postal_code": "326159330",
            "telephone_number": "386-462-7772",
            "fax_number": "386-462-1122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LATOUR",
        "first_name": "LARRY",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "O.D.  P.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-04-22",
        "last_updated": "2008-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC1543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alachua, FL

Sources for this page

Verify at the official NPI Registry.