Individual provider Active NPI

Mariam Labib Latif, M.D.

  • Family Medicine Physician
  • Alpharetta, GA
National Provider Identifier
1265409007
Registry record updated Oct 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
057127 Issued in GA
Practice address
1865 Lockeway Dr Ste 603
Alpharetta, GA 30004-5938
Phone
(770) 752-8440
Fax
(770) 752-8990
NPI assigned
Mar 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 057127 GA Primary

Addresses

Primary practice location

1865 Lockeway Dr Ste 603
Alpharetta, GA 30004-5938

Mailing address

1865 Lockeway Dr Ste 603
Alpharetta, GA 30004-5938
Phone (770) 752-8440

Other identifiers 3

IdentifierTypeStateIssuer
1609816123OtherGEORGIA CLINIC, PC GROUP NPI #
471097851CMedicaidGA
471097851BMedicaidGA

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
I20060623000020 GA Practitioner - Family Practice 6204886286 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1865 Lockeway Dr
Alpharetta, GA 30004-5938
Phone (770) 752-8440

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
057127GAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alphacare Medical Center, PC CurrentSince Jan 4, 2006 Accepting new patients

Locations

1865 Lockeway Dr
Ste 603
Alpharetta, GA 30004
Phone (770) 752-8440

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": "1141171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349136000000",
    "number": "1265409007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1865 LOCKEWAY DR STE 603",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300045938",
            "telephone_number": "770-752-8440",
            "fax_number": "770-752-8990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1865 LOCKEWAY DR STE 603",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300045938",
            "telephone_number": "770-752-8440",
            "fax_number": "770-752-8990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LATIF",
        "first_name": "MARIAM",
        "middle_name": "LABIB",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-01",
        "last_updated": "2012-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "057127",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEORGIA CLINIC, PC GROUP NPI #",
            "identifier": "1609816123",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "471097851C",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "471097851B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alpharetta, GA

Sources for this page

Verify at the official NPI Registry.