Individual provider Active NPI

Latonya Renee Banks, APRN

  • Family Nurse Practitioner
  • Louisville, KY
National Provider Identifier
1629627773
Registry record updated Sep 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3013776 Issued in KY
Practice address
1151 S 4TH St Ste 206
Louisville, KY 40203-3101
Phone
(502) 808-1048
Fax
(866) 951-0629
NPI assigned
Sep 10, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 3013776 KY Primary

Addresses

Primary practice location

1151 S 4TH St Ste 206
Louisville, KY 40203-3101

Mailing address

12024 Lavenia LN Ste 105
Louisville, KY 40272-6100
Phone (502) 302-9241

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191108001185 KY Practitioner - Nurse Practitioner 7315379518 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kiosk Medicine Kentucky LLC 169 clinicians

Practice addresses (Care Compare)

3039 Breckenridge LN
Louisville, KY 40220-2101
Phone (502) 451-4555

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3013776KYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Derby City Medical Partners, LLC Family CurrentSince May 11, 2025 Accepting new patients
Kiosk Medicine Kentucky LLC Family CurrentSince Sep 16, 2025 Accepting new patients
Pearl Medical Practice PLLC PastSince Jan 31, 2021 Accepting new patients

Locations

1151 S 4th St
Ste 206
Louisville, KY 40203
Phone (502) 808-1048

3039 Breckenridge Ln
Louisville, KY 40220
Phone (502) 451-4555

2902 Bardstown Rd
Ste D
Louisville, KY 40205
Phone (502) 808-1048

Interoperability endpoints

  • Direct secure messaging: latonya.banks@krogerhealth.eclinicaldirectplus.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1568073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758240000000",
    "number": "1629627773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12024 LAVENIA LN STE 105",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402726100",
            "telephone_number": "502-302-9241",
            "fax_number": "502-456-0496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1151 S 4TH ST STE 206",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402033101",
            "telephone_number": "502-808-1048",
            "fax_number": "866-951-0629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANKS",
        "first_name": "LATONYA",
        "middle_name": "RENEE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-10",
        "last_updated": "2025-09-19",
        "certification_date": "2025-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3013776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.