Individual provider Active NPI

Lathanikone Langston Louprasong, PA

  • Physician Assistant
  • Kettering, OH
National Provider Identifier
1396171336
Registry record updated Jan 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50.003874 Issued in OH
Practice address
3535 Southern Blvd
Kettering, OH 45429-1221
Phone
(937) 395-6010
Fax
(937) 395-8162
NPI assigned
Sep 23, 2013
Last updated
Jan 18, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Personal Emergency Response Attendant 146D00000X 50003874 OH
Physician Assistant 363A00000X 50.003874 OH Primary

Addresses

Primary practice location

3535 Southern Blvd
Kettering, OH 45429-1221

Mailing address

3737 Southern Blvd Ste 2100
Kettering, OH 45429-1285
Phone (937) 433-5309

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://khnarr.ketthealth.com/FHIR-PROD/api/FHIR/DSTU2/
Direct Messaging Address llouprasong525107@direct.ketteringhealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20131202001416 OH Practitioner - Physician Assistant 7517193279 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Alliance Physicians IncGroup PAC ID 0840104360, 314 clinicians

Practice addresses (Care Compare)

1625 S Alex Rd
West Carrollton, OH 45449-5404
Phone (937) 865-0534

2115 Leiter Rd
Suite 100
Miamisburg, OH 45342-3698
Phone (937) 866-0741

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.8 of 100Reported as group
Quality
73.21
Promoting interoperability
100
Improvement activities
40
Cost
76.12

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
50003874OHMDPersonal Emergency Response Attendant

Practice roles

OrganizationSpecialtyStatusNew patients
Alliance Physicians Inc CurrentSince Oct 1, 2013 Accepting new patients
Alliance Physicians Inc CurrentSince Oct 1, 2013 Accepting new patients

Locations

6438 Wilmington Pike
Ste 220
Dayton, OH 45459

3535 Southern Blvd
Kettering, OH 45429
Phone (937) 298-1221

4403 Far Hills Ave
Kettering, OH 45429
Phone (937) 395-3910

3737 Southern Blvd
Ste 2100
Kettering, OH 45429
Phone (937) 294-1632

4000 Miamisburg Centerville Rd
#230
Miamisburg, OH 45342

2115 Leiter Rd
Ste 100
Miamisburg, OH 45342
Phone (937) 384-6922

1 Prestige Pl
Ste 550
Miamisburg, OH 45342
Phone (937) 752-2306

1625 S Alex Rd
West Carrollton, OH 45449
Phone (937) 865-0534

Organizations & group practices 4

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1379894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610928000000",
    "number": "1396171336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3737 SOUTHERN BLVD STE 2100",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454291285",
            "telephone_number": "937-433-5309",
            "fax_number": "937-298-0287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 SOUTHERN BLVD",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454291221",
            "telephone_number": "937-395-6010",
            "fax_number": "937-395-8162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOUPRASONG",
        "first_name": "LATHANIKONE",
        "middle_name": "LANGSTON",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-09-23",
        "last_updated": "2021-01-18",
        "certification_date": "2021-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "146D00000X",
            "taxonomy_group": "",
            "desc": "Personal Emergency Response Attendant",
            "state": "OH",
            "license": "50003874",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.003874",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://khnarr.ketthealth.com/FHIR-PROD/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "3737 Southern Blvd Ste 2100",
            "city": "Kettering",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454291285",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "llouprasong525107@direct.ketteringhealth.org",
            "affiliation": "N",
            "address_1": "3737 Southern Blvd Ste 2100",
            "city": "Kettering",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454291285",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kettering, OH

Sources for this page

Verify at the official NPI Registry.