Active NPI
Latara V Demps, MD
- Surgery Physician
- Atlanta, GA
National Provider Identifier
1457361206
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 053131
- Practice address
- 1 Baltimore Place NW
Suite 360
Atlanta, GA 30308 - Phone
- (404) 815-7951
- Fax
- (404) 815-7953
- NPI assigned
- Aug 8, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 053131 | GA | Primary |
Addresses
Primary practice location
1 Baltimore Place NW
Suite 360
Atlanta, GA 30308
Mailing address
1 Baltimore Place NW
Suite 360
Atlanta, GA 30308
Phone (404) 815-7951
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 984520065A | Medicaid | GA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 053131 | GA | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| All Executive Healthcare Agency LLC | Current | Accepting new patients |
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154995200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1217808000000",
"number": "1457361206",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 BALTIMORE PLACE NW",
"address_2": "SUITE 360",
"city": "ATLANTA",
"state": "GA",
"postal_code": "30308",
"telephone_number": "404-815-7951",
"fax_number": "404-815-7953"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 BALTIMORE PLACE NW",
"address_2": "SUITE 360",
"city": "ATLANTA",
"state": "GA",
"postal_code": "30308",
"telephone_number": "404-815-7951",
"fax_number": "404-815-7953"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEMPS",
"first_name": "LATARA",
"middle_name": "V",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-08",
"last_updated": "2008-08-04",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "GA",
"license": "053131",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "984520065A",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.