Individual provider Active NPI

Latoya Simone Southwell

  • Doula
  • Nyack, NY
National Provider Identifier
1568190643
Registry record updated Aug 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DoulaTaxonomy code 374J00000X
License
405055996 Issued in NY
Practice address
505 Nyack PLZ
Nyack, NY 10960-3847
Phone
(845) 598-7101
NPI assigned
Aug 8, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Doula 374J00000X 405055996 NY Primary

Addresses

Primary practice location

505 Nyack PLZ
Nyack, NY 10960-3847

Mailing address

505 Nyack PLZ
Nyack, NY 10960-3847
Phone (845) 598-7101

Other identifiers 1

IdentifierTypeStateIssuer
405055996MedicaidNY

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL N/A

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
405055996NYMDDoula

NPI Registry JSON

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

{
    "created_epoch": "1659916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659916800000",
    "number": "1568190643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 NYACK PLZ",
            "city": "NYACK",
            "state": "NY",
            "postal_code": "109603847",
            "telephone_number": "845-598-7101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 NYACK PLZ",
            "city": "NYACK",
            "state": "NY",
            "postal_code": "109603847",
            "telephone_number": "845-598-7101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUTHWELL",
        "first_name": "LATOYA",
        "middle_name": "SIMONE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-08",
        "last_updated": "2022-08-08",
        "certification_date": "2022-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374J00000X",
            "taxonomy_group": "",
            "desc": "Doula",
            "state": "NY",
            "license": "405055996",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "405055996",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "N/A",
            "affiliation": "N",
            "address_1": "505 Nyack Plz",
            "city": "Nyack",
            "state": "NY",
            "country_code": "US",
            "postal_code": "109603847",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Nyack, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2022; 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.