Latasha Pittman, NP
Individual provider Active NPI Nurse Practitioner · Lowell, IN
NPI 1578062535 · NPPES record last updated Mar 16, 2018
Key facts
- NPI
- 1578062535
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 71007749A (IN)
- Practice address
- 2072B E Commercial Ave
Lowell, IN 46356-2116 - Phone
- (219) 696-6880
- NPI assigned
- Feb 6, 2018
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 7
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Southlake Community Mental Health Center Inc
Practice addresses (Care Compare)
8555 Taft St
Merrillville, IN 46410-6123
Phone (219) 769-4005
Hospital & facility affiliations
- Franciscan Health Munster
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180803000369 | IN | Practitioner - Nurse Practitioner | 1456609619 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Arts, Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southlake Community Mental Health Center Inc. | Current |
Accepting new patients |
Locations
3903 Indianapolis Blvd
East Chicago, IN 46312
Phone (219) 392-6001
559 State St
Hammond, IN 46320
Phone (219) 937-3300
8555 Taft St
Merrillville, IN 46410
Phone (219) 736-7232
8400 Louisiana St
Merrillville, IN 46410
Phone (219) 757-1924
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 71007749A | IN | Yes |
Addresses
Primary practice location
2072B E Commercial Ave
Lowell, IN 46356-2116
Mailing address
211 Serena Dr
Chicago Heights, IL 60411-1039
Other providers in Lowell, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 16, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.