Individual provider Active NPI

John Thomas Latham Jr., M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Greenville, SC
National Provider Identifier
1396895249
Registry record updated Oct 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
10301 Issued in SC
Practice address
1 Saint Francis Dr
Greenville, SC 29601-3955
Phone
(864) 322-4167
NPI assigned
Jan 11, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 10301 SC Primary

Addresses

Primary practice location

1 Saint Francis Dr
Greenville, SC 29601-3955

Mailing address

PO Box 9280
Greenville, SC 29604-9280
Phone (800) 528-3448

Other identifiers 1

IdentifierTypeStateIssuer
103015MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100312000235 SC Practitioner - Pathology 2668507930 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
10301SCMDEndodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Upstate Pathology, PA Anatomic Pathology & Clinical Pathology CurrentSince Feb 5, 1993 Accepting new patients

Locations

1 Saint Francis Dr
Greenville, SC 29601
Phone (864) 225-1000

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": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191801600000",
    "number": "1396895249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9280",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296049280",
            "telephone_number": "800-528-3448",
            "fax_number": "864-322-0167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 SAINT FRANCIS DR",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296013955",
            "telephone_number": "864-322-4167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LATHAM",
        "first_name": "JOHN",
        "middle_name": "THOMAS",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-11",
        "last_updated": "2007-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "SC",
            "license": "10301",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103015",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.