Kim Denise Lattimore, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

4741 Issued in GA

Practice address

7950 Martin Loop
Fort Benning, GA 31905-5647

Phone

(706) 573-9363

NPI assigned

Sep 27, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Kim Denise Lattimore Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366533986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7000 FELDSPAR CT",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319092212",
            "telephone_number": "706-507-1185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7950 MARTIN LOOP",
            "city": "FORT BENNING",
            "state": "GA",
            "postal_code": "319055647",
            "telephone_number": "706-573-9363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LATTIMORE",
        "first_name": "KIM",
        "middle_name": "DENISE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "4741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIM",
            "last_name": "LATTIMORE",
            "middle_name": "DENISE",
            "prefix": "MRS.",
            "credential": "PHYSICIAN ASSISTANT",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Blaze Krogh, DMD
• Christopher J Kulhavy, M.D.
• Gregory Martin Lai, MD
• Alexandra Lamb
• Loran Callie Lane, R.D.
• Brandon Launstein
• Marilyn Lawrence, PT
• Cory Layton, DDS
• Veronica Rose Lazar, DPT, PT
• Charolette B Lee

• Physician Assistant in Fort Benning, GA
• Providers in Fort Benning, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.