Individual provider Active NPI

Delbert Latham II, FNP-C

  • Nurse Practitioner
  • Austin, TX
National Provider Identifier
1285279307
Registry record updated Nov 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP144979 Issued in TX
Practice address
10550 W Parmer LN
Austin, TX 78717-4873
Phone
(512) 310-3190
NPI assigned
Nov 13, 2019
Last updated
Nov 30, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP144979 TX Primary
Family Nurse Practitioner 363LF0000X AP144979 TX
Registered Nurse 163W00000X 696424 TX

Addresses

Primary practice location

10550 W Parmer LN
Austin, TX 78717-4873

Mailing address

10550 W Parmer LN
Austin, TX 78717-4873
Phone (512) 310-3190

Other practice location 1

12221 N Mopac Expy
Austin, TX 78758-2401
Phone (512) 901-1100

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20200423002438 TX Practitioner - Nurse Practitioner 0042640500 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
696424TXMDRegistered Nurse
AP144979TXMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Urgent Care PA Nurse Practitioner CurrentSince Jun 1, 2024 Accepting new patients
Longhorn Emergency Medical Associates PA Nurse Practitioner CurrentSince Apr 1, 2020 Accepting new patients
Goodside Health Medical, PLLC Nurse Practitioner Past Accepting new patients

Locations

12221 N Mopac Expy
Austin, TX 78758
Phone (512) 901-2530

919 E 32nd St
Austin, TX 78705
Phone (512) 343-2466

905 E Whitestone Blvd
Ste B
Cedar Park, TX 78613
Phone (512) 690-2377

3750 Gattis School Rd
Ste 900
Round Rock, TX 78664
Phone (512) 501-6576

1640 Lake Woodlands Dr
Ste E
The Woodlands, TX 77380
Phone (281) 367-0010

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1573603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669766400000",
    "number": "1285279307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10550 W PARMER LN",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787174873",
            "telephone_number": "512-310-3190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10550 W PARMER LN",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787174873",
            "telephone_number": "512-310-3190"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12221 N Mopac Expy",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787582401",
            "country_code": "US",
            "telephone_number": "512-901-1100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LATHAM",
        "first_name": "DELBERT",
        "name_prefix": "Mr.",
        "name_suffix": "II",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-11-13",
        "last_updated": "2022-11-30",
        "certification_date": "2022-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP144979",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP144979",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "696424",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.