Latasha Nicole Temple, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AT001984 Issued in GA

Practice address

1975 Highway 54 W
Suite 210
Fayetteville, GA 30214-4794

Phone

(770) 632-2060

NPI assigned

Nov 8, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1320710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320710400000",
    "number": "1477830180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7304 CHADS CIR",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302365702",
            "telephone_number": "404-725-7850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1975 HIGHWAY 54 W",
            "address_2": "SUITE 210",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302144794",
            "telephone_number": "770-632-2060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEMPLE",
        "first_name": "LATASHA",
        "middle_name": "NICOLE",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-08",
        "last_updated": "2011-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "GA",
            "license": "AT001984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tarra Taylor, P.T.
• Thomas K Taylor, MD
• Kelly Teed, MMSC, CGC
• Televatecomp Care
• Tesfaye Telila, MD
• Lacana N Tenn, MLT
• Reddick Ray Matulac Terre, PT
• Tamara Terry, COTA/L
• The Bliss Center, Paracletos Institute International
• The Breast Health Clinic, PC.

• Athletic Trainer in Fayetteville, GA
• Providers in Fayetteville, GA by specialty
• Athletic Trainer in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.