Individual provider Active NPI

Latore Williams

  • Licensed Practical Nurse
  • Stone Mountain, GA
National Provider Identifier
1265829824
Registry record updated Sep 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
LPN82505 Issued in GA
Practice address
5300 Ridge Forest Drive
Stone Mountain, GA 30083
Phone
(404) 399-7713
NPI assigned
Apr 22, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X LPN82505 GA Primary

Addresses

Primary practice location

5300 Ridge Forest Drive
Stone Mountain, GA 30083

Mailing address

5825 Lakeview Cir
Lithonia, GA 30058-1843
Phone (140) 439-9771

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LPN82505GAMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Fragile Fighters Pediatric Home Health LLC Current Accepting new patients
Latore Williams Licensed Practical Nurse Past Accepting new patients
Raymond Licensed Practical Nurse Past Accepting new patients

Organizations & group practices 3

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": "1429660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599782400000",
    "number": "1265829824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5825 LAKEVIEW CIR",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300581843",
            "telephone_number": "140-439-9771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5300 RIDGE FOREST DRIVE",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "30083",
            "telephone_number": "404-399-7713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "LATORE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-22",
        "last_updated": "2020-09-11",
        "certification_date": "2020-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "GA",
            "license": "LPN82505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stone Mountain, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.