Individual provider Active NPI

Louis Lataif Jr., M.D.

  • Gastroenterology Physician
  • Rome, GA
National Provider Identifier
1184688798
Registry record updated Mar 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
042331 Issued in GA
Practice address
11 John Maddox Dr NW
Rome, GA 30165-1413
Phone
(706) 295-3992
Fax
(706) 378-5582
NPI assigned
Apr 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 042331 GA Primary

Addresses

Primary practice location

11 John Maddox Dr NW
Rome, GA 30165-1413

Mailing address

11 John Maddox Dr NW
Rome, GA 30165-1413
Phone (706) 295-3992

Other identifiers 1

IdentifierTypeStateIssuer
00708947BMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110128000780 GA Practitioner - Gastroenterology 4688588106 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
042331GAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rome Gastroenterology Associates Gastroenterology CurrentSince Jun 1, 2000 Accepting new patients

Locations

11 John Maddox Dr NW
Rome, GA 30165
Phone (406) 295-3992

Interoperability endpoints

  • Direct secure messaging: louislataif@rga.allscriptsdirect.net
  • FHIR API: https://fhir.fhirpoint.open.allscripts.com/fhirroute/open/10034072

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.

NPI Registry JSON

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

{
    "created_epoch": "1144800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488844800000",
    "number": "1184688798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 JOHN MADDOX DR NW",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301651413",
            "telephone_number": "706-295-3992",
            "fax_number": "706-378-5582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 JOHN MADDOX DR NW",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301651413",
            "telephone_number": "706-295-3992",
            "fax_number": "706-378-5582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LATAIF",
        "first_name": "LOUIS",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-12",
        "last_updated": "2017-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "GA",
            "license": "042331",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00708947B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rome, GA

Sources for this page

Verify at the official NPI Registry.