Individual provider Active NPI

Latanya Gobin

  • Emergency Medicine Physician
  • Atlanta, GA
National Provider Identifier
1194110635
Registry record updated Aug 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
78042 Issued in GA
Practice address
49 Jesse Hill Jr Dr SE
Atlanta, GA 30303-3049
Phone
(404) 251-8866
Fax
(404) 688-6355
NPI assigned
Apr 1, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 29, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 78042 GA Primary

Addresses

Primary practice location

49 Jesse Hill Jr Dr SE
Atlanta, GA 30303-3049

Mailing address

49 Jesse Hill Jr Dr SE
Atlanta, GA 30303-3049
Phone (404) 251-8866

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
I20181002003840 GA Practitioner - Emergency Medicine 2567764772 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Morehouse School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Bortolazzo Group, LLCGroup PAC ID 3476554320, 98 clinicians

Practice addresses (Care Compare)

3950 Austell Rd
Austell, GA 30106-1121
Phone (770) 732-4000

Hospital & facility affiliations

  • Wellstar Paulding Medical Center Hospital, Hiram, GA, CCN 110042

Merit-based Incentive Payment System (MIPS)

Final score
93.93 of 100Reported as apm
Quality
82.14
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
78042GAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Acs Primary Care Physicians - Southeast PC Emergency Medicine CurrentSince Jan 1, 2020 Accepting new patients
The Bortolazzo Group, LLC Emergency Medicine CurrentSince Mar 20, 2018 Accepting new patients

Locations

3950 Austell Rd
Austell, GA 30106
Phone (770) 732-3752

200 Industrial Blvd
Dublin, GA 31021
Phone (478) 274-3865

2151 W Spring St
Monroe, GA 30655
Phone (770) 267-1792

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1427846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567036800000",
    "number": "1194110635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49 JESSE HILL JR DR SE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303033049",
            "telephone_number": "404-251-8866",
            "fax_number": "404-688-6355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49 JESSE HILL JR DR SE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303033049",
            "telephone_number": "404-251-8866",
            "fax_number": "404-688-6355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOBIN",
        "first_name": "LATANYA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-01",
        "last_updated": "2019-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "78042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.