Individual provider Active NPI

Tido A Latour, CRNA

  • Certified Registered Nurse Anesthetist
  • Johnson City, TN
National Provider Identifier
1457348773
Registry record updated Mar 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
10345 Issued in TN
Practice address
1009 Novus Dr Ste 2
Johnson City, TN 37604-8237
Phone
(423) 283-0776
NPI assigned
Oct 3, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 27158 SC
Certified Registered Nurse Anesthetist 367500000X 10345 TN Primary
Certified Registered Nurse Anesthetist 367500000X RN127822 TN

Addresses

Primary practice location

1009 Novus Dr Ste 2
Johnson City, TN 37604-8237

Mailing address

1009 Novus Dr Ste 2
Johnson City, TN 37604-8237
Phone (423) 283-0776

Other identifiers 5

IdentifierTypeStateIssuer
39792OtherTNTLC
413868097OtherTNTRICARE
4142848OtherTNBLUE CROSS
P00391672OtherRR MEDICARE #
205315OtherTNUNISON

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, KY, SC3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20040422001548 TN Practitioner - Certified Registered Nurse Anesthetist (Crna) 9133115363 Reassigns benefits to 5 organizations
I20060106000540 KY Practitioner - Certified Registered Nurse Anesthetist (Crna) 9133115363 Reassigns benefits to 1 organization
I20230410002019 SC Practitioner - Certified Registered Nurse Anesthetist (Crna) 9133115363 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
10345TNMDClinical Social Worker
27158SCMDCertified Registered Nurse Anesthetist
RN127822TNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Henry County Medical Center CurrentSince Sep 1, 2020 Accepting new patients
Capital Anesthesia Solutions of Kentucky LLC Nurse Anesthetist, Certified Registered CurrentSince Jan 10, 2025 Accepting new patients
Paragon Anesthesia PC Nurse Anesthetist, Certified Registered CurrentSince Aug 16, 2022 Accepting new patients
Lexington Health Inc CurrentSince Mar 17, 2023 Accepting new patients
Lexington Health Inc Nurse Anesthetist, Certified Registered CurrentSince Mar 17, 2023 Accepting new patients
American Anesthesiology of Tennessee, P.C. CurrentSince Aug 26, 2022 Accepting new patients
American Anesthesiology of Tennessee, P.C. Nurse Anesthetist, Certified Registered CurrentSince Aug 26, 2022 Accepting new patients
West Tennessee Healthcare Henry County Nurse Anesthetist, Certified Registered CurrentSince Sep 1, 2020 Accepting new patients
Lexington Health Inc Current Accepting new patients
Resource Anesthesia, P.C. Nurse Anesthetist, Certified Registered CurrentSince May 15, 2014 Accepting new patients
Anesthesia Dynamics LLC Nurse Anesthetist, Certified Registered CurrentSince Jul 1, 2020 Accepting new patients
Otolaryngology Head and Neck Surgery Associates CurrentSince May 31, 2021 Accepting new patients
Henry County Medical Center Current Accepting new patients
East Tennessee Ambulatory Surgery Center LLC CurrentSince Aug 16, 2022 Accepting new patients
Hamblen Anesthesia PC Nurse Anesthetist, Certified Registered PastSince Mar 13, 1995 Accepting new patients
Singing River Health System Past Accepting new patients
Anesthesia Healthcare Partners, Inc. Nurse Anesthetist, Certified Registered Past Accepting new patients
Millennium Anesthesia PA Past Accepting new patients
Unity Urology PC PastSince Sep 15, 2006 Accepting new patients
Anesthesia Associates Northwest LLC Past Accepting new patients

Locations

723 Burkesville Rd
Albany, KY 42602
Phone (606) 387-6421

305 Langdon St
Somerset, KY 42503
Phone (606) 451-2994

1305 Walt Whitman Rd
Ste 300
Melville, NY 11747
Phone (516) 370-3796

7035 Saint Andrews Rd
Columbia, SC 29212
Phone (803) 749-0924

811 W Main St
Ste 101
Lexington, SC 29072
Phone (803) 936-7230

2720 Sunset Blvd
West Columbia, SC 29169
Phone (803) 791-2480

1 Medical Park Blvd
Bristol, TN 37620
Phone (423) 390-0451

310 N State of Franklin Rd
Ste 202
Johnson City, TN 37604
Phone (423) 434-3700

10415 Wallace Alley St
Kingsport, TN 37663
Phone (423) 390-0451

144 Concord Rd
Knoxville, TN 37934

12752 Kingston Pike
Ste E202
Knoxville, TN 37934
Phone (877) 277-9030

12752 Kingston Pike
Ste E2
Knoxville, TN 37934

9300 Park West Blvd
Knoxville, TN 37923
Phone (865) 427-4040

550 Fort Loudoun Med Center Dr
Lenoir City, TN 37772
Phone (865) 271-6000

550 Fort Loudon Medical Center Dr
#C
Lenoir City, TN 37772

301 Tyson Ave
Paris, TN 38242
Phone (731) 642-1220

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/b673e6c7-c87b-498f-86b2-99b24c52c924/
  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.240001
  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.240000

Organizations & group practices 20

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.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1128297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679011200000",
    "number": "1457348773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1009 NOVUS DR STE 2",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376048237",
            "telephone_number": "423-283-0776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1009 NOVUS DR STE 2",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376048237",
            "telephone_number": "423-283-0776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LATOUR",
        "first_name": "TIDO",
        "middle_name": "A",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-03",
        "last_updated": "2023-03-17",
        "certification_date": "2023-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "SC",
            "license": "27158",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "10345",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "RN127822",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TLC",
            "identifier": "39792",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "413868097",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "4142848",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE #",
            "identifier": "P00391672",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNISON",
            "identifier": "205315",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.