Individual provider Active NPI

Nathaniel Latimore, RN

  • Registered Nurse First Assistant
  • Lagrange, GA
National Provider Identifier
1134825730
Registry record updated Feb 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered Nurse First AssistantTaxonomy code 163WR0006X
License
RN278246 Issued in GA
Practice address
608 Winzor Ave
Lagrange, GA 30240-2166
Phone
(706) 333-0653
NPI assigned
Feb 6, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse First Assistant 163WR0006X RN278246 GA Primary

Addresses

Primary practice location

608 Winzor Ave
Lagrange, GA 30240-2166

Mailing address

608 Winzor Ave
Lagrange, GA 30240-2166
Phone (706) 333-0653

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 Nurse

State licenses

LicenseStateTypeSpecialty
RN278246GAMDRegistered Nurse First Assistant

NPI Registry JSON

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

{
    "created_epoch": "1675641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675641600000",
    "number": "1134825730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "608 WINZOR AVE",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302402166",
            "telephone_number": "706-333-0653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "608 WINZOR AVE",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302402166",
            "telephone_number": "706-333-0653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LATIMORE",
        "first_name": "NATHANIEL",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-02-06",
        "last_updated": "2023-02-06",
        "certification_date": "2023-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WR0006X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Registered Nurse First Assistant",
            "state": "GA",
            "license": "RN278246",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lagrange, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 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.

Verify at the official NPI Registry.