Individual provider Active NPI

Ami Latham, CRNP

  • Adult Health Nurse Practitioner
  • Pell City, AL
National Provider Identifier
1194312124
Registry record updated Dec 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
1-150372 Issued in AL
Practice address
70 Plaza Dr
Pell City, AL 35125-9314
Phone
(205) 814-9284
Fax
(205) 814-9626
NPI assigned
Dec 23, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 1-150372 AL Primary

Addresses

Primary practice location

70 Plaza Dr
Pell City, AL 35125-9314

Mailing address

70 Plaza Dr
Pell City, AL 35125-9314
Phone (205) 814-9284

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210127001790 AL Practitioner - Nurse Practitioner 5890109151 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

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": "1608681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608681600000",
    "number": "1194312124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 PLAZA DR",
            "city": "PELL CITY",
            "state": "AL",
            "postal_code": "351259314",
            "telephone_number": "205-814-9284",
            "fax_number": "205-814-9626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 PLAZA DR",
            "city": "PELL CITY",
            "state": "AL",
            "postal_code": "351259314",
            "telephone_number": "205-814-9284",
            "fax_number": "205-814-9626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LATHAM",
        "first_name": "AMI",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-23",
        "last_updated": "2020-12-23",
        "certification_date": "2020-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AL",
            "license": "1-150372",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pell City, AL

Sources for this page

Verify at the official NPI Registry.