Latisha Marie Ward
Individual provider Active NPI Family Nurse Practitioner · Stanton, TX
NPI 1609341007 · NPPES record last updated Feb 8, 2023
Key facts
- NPI
- 1609341007
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- AP139148 (TX)
- Practice address
- 600 East Interstate 20
Stanton, TX 79782 - Phone
- (432) 607-3200
- NPI assigned
- Oct 11, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- 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 |
|---|---|---|---|---|
| I20190521002209 | TX | Practitioner - Nurse Practitioner | 7517200215 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AP139148 | TX | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Martin County Hospital District | Current |
Accepting new patients | |
| Healogics Specialty Physicians of Texas, PLLC | Family Medicine | Current |
Accepting new patients |
| Martin County Hospital District | Current |
Accepting new patients |
Locations
5220 Belfort Rd
Ste 130
Jacksonville, FL 32256
Phone (904) 446-3686
1105 Central Expy N
Ste 2210
Allen, TX 75013
Phone (972) 747-4325
1501 W 11th Pl
Ste 106
Big Spring, TX 79720
Phone (432) 267-1611
500 W 4th St
Odessa, TX 79761
Phone (432) 640-1000
600 E Interstate 20
Stanton, TX 79782
Phone (432) 607-3200
Interoperability endpoints
- latisha.ward.1@3522.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | AP139148 | TX | |
| Family Nurse Practitioner | 363LF0000X | AP139148 | TX | Yes |
Addresses
Primary practice location
600 East Interstate 20
Stanton, TX 79782
Mailing address
PO Box 640
Stanton, TX 79782-0640
Phone (432) 607-3200
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8LD678 | Other | TX | BCBS TX |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | latisha.ward.1@3522.direct.athenahealth.com | Direct |
Other providers in Stanton, TX
- Stanton Drug LLC
- Stanton Nursing and Rehabilitation LP
- Shalon Lena Sullivan
- Trulite Home Care, Inc.
- Elizabeth Ann Vanderslice
- Kelli Mary-Ruth Woody
All providers in Stanton, TX · Family Nurse Practitioner in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 8, 2023. 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).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.