Individual provider Active NPI

Latarsha Selwyna Cheatham, FNP-BC

  • Nurse Practitioner
  • Houston, TX
National Provider Identifier
1356383855
Registry record updated Nov 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
673237 Issued in TX
Practice address
6720 Bertner St
MC 4-278 Box 112
Houston, TX 77030-2604
Phone
(713) 785-8537
Fax
(832) 355-6865
NPI assigned
Jun 11, 2006
Last updated
Nov 5, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 673237 TX Primary

Addresses

Primary practice location

6720 Bertner St
MC 4-278 Box 112
Houston, TX 77030-2604

Mailing address

12310 Broken Creek LN
Pearland, TX 77584-9730
Phone (281) 993-4293

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
673237TXMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Clyde McMorris MD PA PastSince Nov 24, 2024 Accepting new patients
CHI St Luke's Health Baylor St. Luke's Medical Center Past Accepting new patients

Organizations & group practices 2

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": "1149984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257379200000",
    "number": "1356383855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12310 BROKEN CREEK LN",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775849730",
            "telephone_number": "281-993-4293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6720 BERTNER ST",
            "address_2": "MC 4-278 BOX 112",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302604",
            "telephone_number": "713-785-8537",
            "fax_number": "832-355-6865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEATHAM",
        "first_name": "LATARSHA",
        "middle_name": "SELWYNA",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-11",
        "last_updated": "2009-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "673237",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.