Individual provider Active NPI

Latrina Kingsby, RN

  • Registered Nurse
  • Milwaukee, WI
National Provider Identifier
1164185773
Registry record updated Oct 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
168145 Issued in WI
Practice address
4911 W Good Hope Rd Unit D
Milwaukee, WI 53223-4840
Phone
(414) 405-9002
NPI assigned
Oct 20, 2021
Last updated
Oct 20, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 168145 WI Primary

Addresses

Primary practice location

4911 W Good Hope Rd Unit D
Milwaukee, WI 53223-4840

Mailing address

7034 N 55TH St Apt C
Milwaukee, WI 53223-6336
Phone (414) 405-9002

Other names 1

  • Latrina Ellis Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL clinicalabwork Health Information Exchange (HIE)

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
168145WIMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Essence of Truth Clinical Lab, LLC CurrentSince Jan 26, 2022 Accepting new patients
Essence of Truth SHPC Current Accepting new patients
Healthwise Education Training Solutions Single Specialty Current Accepting new patients

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1634688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634688000000",
    "number": "1164185773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7034 N 55TH ST APT C",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532236336",
            "telephone_number": "414-405-9002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4911 W GOOD HOPE RD UNIT D",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532234840",
            "telephone_number": "414-405-9002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINGSBY",
        "first_name": "LATRINA",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-20",
        "last_updated": "2021-10-20",
        "certification_date": "2021-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "168145",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "clinicalabwork",
            "affiliation": "N",
            "endpointDescription": "lab",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4911 W Good Hope Rd Unit D",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532234840",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "LATRINA",
            "last_name": "ELLIS",
            "credential": "LPN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2021; 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.