Kim Marie Latterner, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

MA001899L Issued in PA

Practice address

115 Hickory Dr
Manchester, PA 17345-9502

Phone

(717) 266-6784

NPI assigned

Aug 3, 2006

Last updated

Dec 19, 2011By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Kim Marie Myers Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

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  • NPI 1275072662
  NPD (past)

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324252800000",
    "number": "1356359889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 HICKORY DR",
            "city": "MANCHESTER",
            "state": "PA",
            "postal_code": "173459502",
            "telephone_number": "717-266-6784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 HICKORY DR",
            "city": "MANCHESTER",
            "state": "PA",
            "postal_code": "173459502",
            "telephone_number": "717-266-6784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LATTERNER",
        "first_name": "KIM",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-03",
        "last_updated": "2011-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0002815",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA001899L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIM",
            "last_name": "MYERS",
            "middle_name": "MARIE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• James P. Tuttle, OD (Wheatlyn EyeCare)
• Kylie Keeney, MS, CCC-SLP
• Jena R. Khera, MD
• Derek Kramer, O.D.
• Kimberly N Kurland, D.O.
• Andrew L Leitzel, O.D.
• Laura Leigh Lenart, PHARMD
• Mainline Urgent Care Medical Group
• Alock Malik
• Manchester Ambulance Club (Northeastern Area EMS)

• Medical Physician Assistant in Manchester, PA
• Providers in Manchester, PA by specialty
• Medical Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2011; 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.