Jerry Wayne Latch

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

12758939 Issued in MS

Practice address

206 N Fillmore St
Corinth, MS 38834

Phone

(662) 286-8064

Fax

(662) 286-8064

NPI assigned

Jun 26, 2018

Last updated

Jun 27, 2018By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Practice roles

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.

• Joes Shoes

  • Durable Medical Equipment & Medical Supplies
  • Corinth, MS
  • NPI 1295220762
  NPD (past) Authorized official

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

{
    "created_epoch": "1529971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530057600000",
    "number": "1538654199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 N FILLMORE ST",
            "city": "CORINTH",
            "state": "MS",
            "postal_code": "388345634",
            "telephone_number": "662-286-8064",
            "fax_number": "662-286-8064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 N FILLMORE ST",
            "city": "CORINTH",
            "state": "MS",
            "postal_code": "38834",
            "telephone_number": "662-286-8064",
            "fax_number": "662-286-8064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LATCH",
        "first_name": "JERRY",
        "middle_name": "WAYNE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-06-26",
        "last_updated": "2018-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MS",
            "license": "12758939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kossuth Family Health Clinic
• Kroger Limited Partnership I (Kroger Pharmacy)
• Labtech, Inc
• Gary D Lacom, DDS
• Vickie Lambert, NP
• C Spencer Lee, DDS
• Jennifer Grace Lindsey, MD
• Linsay Ling, MD
• Conor Edward Lingard, DO
• Leah Creason Locke, M.S.

• Durable Medical Equipment & Medical Supplies in Corinth, MS
• Providers in Corinth, MS by specialty
• Durable Medical Equipment & Medical Supplies in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2018; 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.