Latoya Dimitra Buchanan, FNP-BC

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

5013479 Issued in NC

Practice address

264 Averasboro Dr.
Clayton, NC 27520

Phone

(919) 432-7395

NPI assigned

Sep 25, 2013

Last updated

Apr 8, 2026By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Latoya Dimitra Champ Former name

Medicare fee-for-service enrollment

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Dedicated Physicians Group of Texas PLLC

  dba Dedicated Senior Medical Center

  • Internal Medicine Physician
  • Miami Gardens, FL
  • NPI 1174141899

  TX

  Medicare reassignment NPD

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

{
    "created_epoch": "1380067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775606400000",
    "number": "1225464043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "264 AVERASBORO DR.",
            "city": "CLAYTON",
            "state": "NC",
            "postal_code": "27520",
            "telephone_number": "919-432-7395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "264 AVERASBORO DR.",
            "city": "CLAYTON",
            "state": "NC",
            "postal_code": "27520",
            "telephone_number": "919-432-7395"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8411 W Bellfort Ave",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770712205",
            "country_code": "US",
            "telephone_number": "713-429-0808",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUCHANAN",
        "first_name": "LATOYA",
        "middle_name": "DIMITRA",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-25",
        "last_updated": "2026-04-08",
        "certification_date": "2026-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NC",
            "license": "5013479",
            "primary": true
        },
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "NC",
            "license": "240383",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LATOYA",
            "last_name": "CHAMP",
            "middle_name": "DIMITRA",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Demonique Brown, D.C.
• Stephanie Lynn Brown, DDS
• Richard M Browne, PA
• Anna Sullivan Bruton, ANP-C
• Angela Harper Bryan
• Monica Buchanan
• Hunter Samuel Buckley, DC
• Taylor Budzynski, DPT
• Building Bridges Adult Residential Treatment Facility, LLC
• Building Bridges Durable Medical Equipment and Supplies, LLC

• Primary Care Nurse Practitioner in Clayton, NC
• Providers in Clayton, NC by specialty
• Primary Care Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.