Ricky Dwayne Latham, MD

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

MD170342 Issued in OR

Practice address

2001 Valenica Drive
Suite 201
Idaho Falls, ID 83404

Phone

(208) 524-9400

Fax

(208) 524-9401

NPI assigned

Jul 26, 2005

Last updated

Feb 13, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in ID, OR2 enrollments

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 2

Specialty

Interventional CardiologyAlso: Internal Medicine

Education

Louisiana State University School of Medicine in Shreveport, 1979

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

BMH IncGroup PAC ID 8426149758, shared by 7 NPIs, 137 clinicians

Bingham Memorial HospitalGroup PAC ID 8426955014, 68 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Bingham Memorial Hospital Hospital, Blackfoot, ID, CCN 131325
• Eastern Idaho Regional Medical Center Hospital, Idaho Falls, ID, CCN 130018
• Mountain View Hospital Hospital, Idaho Falls, ID, CCN 130065
• Portneuf Medical Center Hospital, Pocatello, ID, CCN 130028
• Caribou Medical Center Hospital, Soda Springs, ID, CCN 131309

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/5838/brand/1/csg/1/fhir/r4
• Direct secure messaging: rickylatham@bmh.medalliesdirect.net

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.

• BMH Inc

  • Critical Access Hospital
  • Blackfoot, ID
  • NPI 1982805271
  Medicare reassignment NPD
• BMH, Inc.

  dba Bingham Memorial Physicians & Surgeons Center

  • Surgery Physician
  • Blackfoot, ID
  • NPI 1255539193

  Internal Medicine

  Medicare reassignment NPD
• Bay Area Hospital District

  dba Bay Area Hospital

  • General Acute Care Hospital
  • Coos Bay, OR
  • NPI 1225016561
  Medicare reassignment NPD
• St Mark's Professional Services, LLC

  • Internal Medicine Physician
  • Salt Lake City, UT
  • NPI 1912925629

  ID

  Medicare reassignment NPD
• BMH, Inc.

  dba 1st Choice Urgent Care & Medical Center-Chubbuck

  • Family Medicine Physician
  • Pocatello, ID
  • NPI 1295502995
  NPD
• BMH, Inc.

  dba Bingham Memorial Specialty Clinic - Poplar

  • Nephrology Physician
  • Blackfoot, ID
  • NPI 1801336276

  Cardiovascular Disease

  NPD
• Bay Area Hospital District

  • Home Health Agency
  • North Bend, OR
  • NPI 1215018197
  NPD
• BMH Inc.

  dba Idaho Physicians Clinic

  • Rural Health Clinic/Center
  • Blackfoot, ID
  • NPI 1770785875
  NPD (past)
• BMH, Inc

  dba Bingham Healthcare Specialty Clinic - Terry St

  • Endocrinology, Diabetes & Metabolism Physician
  • Pocatello, ID
  • NPI 1255705786

  Internal Medicine

  NPD (past)
• Eastern Idaho Cardiology Associates, PLLC

  • Cardiovascular Disease Physician
  • Idaho Falls, ID
  • NPI 1508866260
  NPD (past)
• Radial First Holdings

  dba Radial First Heart Clinic

  • Interventional Cardiology Physician
  • Idaho Falls, ID
  • NPI 1346713302
  NPD (past)
• Fairbanks Memorial Cardiology Center

  • Cardiovascular Disease Physician
  • Fairbanks, AK
  • NPI 1881723807
  NPD (past)

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

• BMH Inc

  • Critical Access Hospital
  • Blackfoot, ID
  • NPI 1982805271
  Care Compare affiliation
• Caribou Medical Center, Inc

  dba Caribou Medical Center

  • Critical Access Hospital
  • Soda Springs, ID
  • NPI 1942970272
  Care Compare affiliation
• Eastern Idaho Health Services Inc

  dba Eastern Idaho Regional Medical Center

  • General Acute Care Hospital
  • Idaho Falls, ID
  • NPI 1225082209
  Care Compare affiliation
• Mountain View Hospital LLC

  • General Acute Care Hospital
  • Idaho Falls, ID
  • NPI 1669462362
  Care Compare affiliation
• Pocatello Hospital LLC

  dba Portneuf Rehabilitation Center

  • Rehabilitation Hospital Unit
  • Pocatello, ID
  • NPI 1144262114
  Care Compare affiliation
• Pocatello Hospital LLC

  dba Portneuf Medical Center

  • General Acute Care Hospital
  • Pocatello, ID
  • NPI 1790751055
  Care Compare affiliation

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

{
    "created_epoch": "1122336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550016000000",
    "number": "1477553139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1775 THOMPSON RD",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974202125",
            "telephone_number": "541-266-4650",
            "fax_number": "541-266-4659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 VALENICA DRIVE",
            "address_2": "SUITE 201",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "83404",
            "telephone_number": "208-524-9400",
            "fax_number": "208-524-9401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LATHAM",
        "first_name": "RICKY",
        "middle_name": "DWAYNE",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-26",
        "last_updated": "2019-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "ID",
            "license": "M6887",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "OR",
            "license": "MD170342",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brandy Lee Larson, FNP
• Gracie Larson
• Ryan Larson
• Tyler J. Larson, DPT
• Kari Anne Lasco-Sanders, DPT
• Latino Stand Up
• Latino Stand Up
• Latino Stand Up Idaho LLC (Latino Stand Up)
• Latino Stand Up Idaho LLC (Latino Stand Up LLC)
• Gary J Lattimore, OD

• Cardiovascular Disease Physician in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Cardiovascular Disease Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.