Individual provider Active NPI

Heshaam A Latifi

  • Family Medicine Physician
  • Kirksville, MO
National Provider Identifier
1497591366
Registry record updated Nov 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2025048999 Issued in MO
Practice address
315 S Osteopathy Ave
Kirksville, MO 63501-6401
Phone
(660) 785-1000
NPI assigned
Jul 1, 2024
Last updated
Nov 25, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 2025048999 MO
Family Medicine Physician 207Q00000X 2025048999 MO Primary

Addresses

Primary practice location

315 S Osteopathy Ave
Kirksville, MO 63501-6401

Mailing address

315 S Osteopathy Ave
Kirksville, MO 63501-6401
Phone (630) 597-8642

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20260221000311 MO Practitioner - Family Practice 0244711810 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1205 N Missouri St
Macon, MO 63552-2095

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2025048999MOMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Macon County Samaritan Hospital CurrentSince Jan 18, 2026 Accepting new patients

Locations

1205 N Missouri St
Macon, MO 63552
Phone (660) 385-3151

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1719792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764028800000",
    "number": "1497591366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 S OSTEOPATHY AVE",
            "city": "KIRKSVILLE",
            "state": "MO",
            "postal_code": "635016401",
            "telephone_number": "630-597-8642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 S OSTEOPATHY AVE",
            "city": "KIRKSVILLE",
            "state": "MO",
            "postal_code": "635016401",
            "telephone_number": "660-785-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LATIFI",
        "first_name": "HESHAAM",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-07-01",
        "last_updated": "2025-11-25",
        "certification_date": "2025-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MO",
            "license": "2025048999",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2025048999",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirksville, MO

Sources for this page

Verify at the official NPI Registry.