Individual provider Active NPI

Latrisha Marie Jantz, LSA

  • Surgical Assistant
  • Dallas, TX
National Provider Identifier
1265876924
Registry record updated Nov 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical AssistantTaxonomy code 246ZC0007X
License
154638 Issued in TX
Practice address
9101 N Central Expy
Suite 600
Dallas, TX 75231-5927
Phone
(214) 823-1691
Fax
(214) 821-7089
NPI assigned
Apr 24, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Assistant 246ZC0007X SA00668 TX
Surgical Technologist 246ZS0410X 143216
Surgical Assistant 246ZC0007X 154638 TX Primary
Licensed Vocational Nurse 164X00000X 310225 TX

Addresses

Primary practice location

9101 N Central Expy
Suite 600
Dallas, TX 75231-5927

Mailing address

1202 E Arapaho Rd Ste 600
Richardson, TX 75081-2400
Phone (469) 250-4422

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
310225TXMDLicensed Vocational Nurse
154638TXMDSurgical Assistant
SA00668TXMDSurgical Assistant

NPI Registry JSON

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

{
    "created_epoch": "1366761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606089600000",
    "number": "1265876924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1202 E ARAPAHO RD STE 600",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750812400",
            "telephone_number": "469-250-4422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9101 N CENTRAL EXPY",
            "address_2": "SUITE 600",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752315927",
            "telephone_number": "214-823-1691",
            "fax_number": "214-821-7089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANTZ",
        "first_name": "LATRISHA",
        "middle_name": "MARIE",
        "name_prefix": "Miss",
        "credential": "LSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-24",
        "last_updated": "2020-11-23",
        "certification_date": "2020-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": "TX",
            "license": "SA00668",
            "primary": false
        },
        {
            "code": "246ZS0410X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Technologist",
            "state": null,
            "license": "143216",
            "primary": false
        },
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": "TX",
            "license": "154638",
            "primary": true
        },
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "TX",
            "license": "310225",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 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.