Individual provider Active NPI

Andrew Paul Latanishen, DC

  • Chiropractor
  • Ephrata, PA
National Provider Identifier
1376543348
Registry record updated Mar 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC003612 Issued in PA
Practice address
4233 Oregon Pike
Ephrata, PA 17522-9450
Phone
(717) 859-4222
Fax
(717) 859-1562
NPI assigned
Jul 29, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC003612 PA Primary
Radiology Chiropractor 111NR0200X DC003612 PA

Addresses

Primary practice location

4233 Oregon Pike
Ephrata, PA 17522-9450

Mailing address

4233 Oregon Pike
Ephrata, PA 17522-9450
Phone (717) 859-4222

Other identifiers 1

IdentifierTypeStateIssuer
105553D5EOtherPARENDERING PROVIDER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120222000504 PA Practitioner - Chiropractic 1658539655 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4233 Oregon Pike
Ephrata, PA 17522-9450
Phone (717) 859-4222

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC003612PAMDRadiology Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Lancaster Health Associates P C Latanishen Chiropractic Chiropractor CurrentSince Dec 18, 1987 Accepting new patients

Locations

4233 Oregon Pike
Ephrata, PA 17522
Phone (717) 859-4222

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1122595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205193600000",
    "number": "1376543348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4233 OREGON PIKE",
            "city": "EPHRATA",
            "state": "PA",
            "postal_code": "175229450",
            "telephone_number": "717-859-4222",
            "fax_number": "717-859-1562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4233 OREGON PIKE",
            "city": "EPHRATA",
            "state": "PA",
            "postal_code": "175229450",
            "telephone_number": "717-859-4222",
            "fax_number": "717-859-1562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LATANISHEN",
        "first_name": "ANDREW",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-29",
        "last_updated": "2008-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC003612",
            "primary": true
        },
        {
            "code": "111NR0200X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Radiology",
            "state": "PA",
            "license": "DC003612",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RENDERING PROVIDER",
            "identifier": "105553D5E",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ephrata, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.