NPIMap

Individual provider Active NPI

Kerry Patricia Latham, MD

  • Plastic Surgery Physician
  • Miami, FL
National Provider Identifier
1588733562
Registry record updated Jan 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
ME92290 Issued in FL
Practice address
1611 NW 12TH Ave
Et3019
Miami, FL 33136-1005
Phone
(305) 585-5285
NPI assigned
Nov 6, 2006
Last updated
Jan 7, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X 0101259723 VA
Plastic Surgery Physician 208200000X ME92290 FL Primary
Surgery Physician 208600000X 0101259723 VA

Addresses

Primary practice location

1611 NW 12TH Ave
Et3019
Miami, FL 33136-1005

Mailing address

2101 Brickell Ave Apt 403
Miami, FL 33129-2102
Phone (210) 385-3500

Other practice location 1

600 Gresham Dr Ste 204
Norfolk, VA 23507-1904
Phone (757) 388-5680

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, AK, TX3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20211209002879 VA Practitioner - Plastic and Reconstructive Surgery 7911145487 Reassigns benefits to 1 organization
I20240801003730 AK Practitioner - Plastic and Reconstructive Surgery 7911145487 Reassigns benefits to 1 organization
I20240813004242 TX Practitioner - Plastic and Reconstructive Surgery 7911145487 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Plastic Surgeons of Alaska LLCGroup PAC ID 8921157793, 5 clinicians

Practice addresses (Care Compare)

2741 Debarr Rd
Suite C215
Anchorage, AK 99508-2978
Phone (907) 563-2002

4315 Diplomacy Dr
Anchorage, AK 99508-5926
Phone (907) 563-2662

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy1-10
Melanoma (skin cancer) excision1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101259723VAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sentara Medical Group CurrentSince Nov 26, 2021 Accepting new patients
Alaska Native Tribal Health Consortium CurrentSince Jul 30, 2024 Accepting new patients
Plastic Surgeons of Alaska, LLC Plastic Surgery CurrentSince Jun 6, 2024 Accepting new patients
Michael Manuel,MD,PC Plastic Surgery PastSince Jun 6, 2024 Accepting new patients

Locations

2741 Debarr Rd
Ste C215
Anchorage, AK 99508
Phone (907) 563-2002

301 W Northern Lights Blvd
Ste 110
Anchorage, AK 99503
Phone (907) 563-2002

4000 Ambassador Dr
Anchorage, AK 99508
Phone (907) 729-1900

4315 Diplomacy Dr
Anchorage, AK 99508
Phone (907) 729-1729

301 Riverview Ave
Ste 400
Norfolk, VA 23510
Phone (757) 252-1700

600 Gresham Dr
Ste 204
Norfolk, VA 23507
Phone (757) 388-5680

850 Kempsville Rd
Norfolk, VA 23502
Phone (757) 261-0162

Interoperability endpoints

  • Direct secure messaging: klatham526506@direct.umm.edu

Organizations & group practices 4

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 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641513600000",
    "number": "1588733562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 BRICKELL AVE APT 403",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331292102",
            "telephone_number": "210-385-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 NW 12TH AVE",
            "address_2": "ET3019",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331361005",
            "telephone_number": "305-585-5285"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 Gresham Dr Ste 204",
            "address_purpose": "LOCATION",
            "city": "Norfolk",
            "state": "VA",
            "postal_code": "235071904",
            "country_code": "US",
            "telephone_number": "757-388-5680",
            "fax_number": "757-510-9157",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LATHAM",
        "first_name": "KERRY",
        "middle_name": "PATRICIA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-06",
        "last_updated": "2022-01-07",
        "certification_date": "2022-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "VA",
            "license": "0101259723",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "FL",
            "license": "ME92290",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "VA",
            "license": "0101259723",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.