Active NPI
Latasha Wimberly
- Case Manager/Care Coordinator
- Farmerville, LA
National Provider Identifier
1124676283
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- Practice address
- 104 W Bayou St
Farmerville, LA 71241-2802 - Phone
- (318) 368-2300
- NPI assigned
- Aug 30, 2019
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | Primary |
Addresses
Primary practice location
104 W Bayou St
Farmerville, LA 71241-2802
Mailing address
1177 Marion Hwy 33
Farmerville, LA 71241-2802
Phone (318) 368-2300
Other practice location 1
102B W Bayou St
Farmerville, LA 71241-2802
Phone (318) 982-8102
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cognitive Development Center Behavioral Health Services | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Monroe, LA
- NPI 1992187322
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1567123200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1699833600000",
"number": "1124676283",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1177 MARION HWY 33",
"city": "FARMERVILLE",
"state": "LA",
"postal_code": "712412802",
"telephone_number": "318-368-2300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "104 W BAYOU ST",
"city": "FARMERVILLE",
"state": "LA",
"postal_code": "712412802",
"telephone_number": "318-368-2300"
}
],
"practiceLocations": [
{
"address_1": "102B W Bayou St",
"address_purpose": "LOCATION",
"city": "Farmerville",
"state": "LA",
"postal_code": "712412802",
"country_code": "US",
"telephone_number": "318-982-8102",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WIMBERLY",
"first_name": "LATASHA",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-08-30",
"last_updated": "2023-11-13",
"certification_date": "2023-11-10",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Farmerville, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.