Individual provider Active NPI

Kristopher Brandon-Paul Latour, MD

  • Student in an Organized Health Care Education/Training Program
  • Monroe, NC
National Provider Identifier
1548964778
Registry record updated Jun 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1106 Reynolds St
Monroe, NC 28112-4375
Phone
(704) 667-9772
Fax
(704) 667-9798
NPI assigned
Mar 30, 2023
Last updated
Jun 16, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NC Primary

Addresses

Primary practice location

1106 Reynolds St
Monroe, NC 28112-4375

Mailing address

1441 N 12TH St FL 2
Phoenix, AZ 85006-2837
Phone (602) 521-5969

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20260518002075 NC Practitioner - Family Practice 2769918580 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of North Carolina at Chapel Hill School of Medicine, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1025 Peerless Xing NW
Cleveland, TN 37312-3764

10430 Alexander Martin Ave
Charlotte, NC 28277-8192

4435 Golf Acres Dr
Charlotte, NC 28208-5947

PO Box
Suite 19305
Charlotte, NC 28219

National Provider Directory

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

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.

NPI Registry JSON

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

{
    "created_epoch": "1680134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781568000000",
    "number": "1548964778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1441 N 12TH ST FL 2",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850062837",
            "telephone_number": "602-521-5969",
            "fax_number": "602-521-5987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1106 REYNOLDS ST",
            "city": "MONROE",
            "state": "NC",
            "postal_code": "281124375",
            "telephone_number": "704-667-9772",
            "fax_number": "704-667-9798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LATOUR",
        "first_name": "KRISTOPHER",
        "middle_name": "BRANDON-PAUL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-30",
        "last_updated": "2026-06-16",
        "certification_date": "2026-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, NC

Sources for this page

Verify at the official NPI Registry.