Individual provider Active NPI

Erin Jennifer Latimer, MD

  • Pediatrics Physician
  • Sand Springs, OK
National Provider Identifier
1649531484
Registry record updated Jul 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
33897 Issued in OK
Practice address
102 S Main St
Sand Springs, OK 74063-6509
Phone
(918) 245-2286
Fax
(918) 241-4366
NPI assigned
Jun 7, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 33897 OK Primary

Addresses

Primary practice location

102 S Main St
Sand Springs, OK 74063-6509

Mailing address

6600 S Yale Ave Ste 1200
Tulsa, OK 74136-3361
Phone (918) 488-6045

Other practice location 1

620 N Carriage Pkwy
Wichita, KS 67208-4501
Phone (316) 962-3100

Other practice location 2

140 West 151st. Street South
Suite 202
Glenpool, OK 74033
Phone (918) 321-7400

Other names 1

  • Erin Jennifer Kenny Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180702002334 OK Practitioner - Pediatric Medicine 6002064722 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
33897OKMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
National Family Medical Associates, LLC CurrentSince May 15, 2023 Accepting new patients
Wesley Pathology Consultants PA Current Accepting new patients
Birth & Beyond Pediatrics, P.C. Pediatrics Past Accepting new patients
Saint Francis Hospital, Inc. Past Accepting new patients

Locations

601 S Harbour Island Blvd
Ste 200
Tampa, FL 33602
Phone (727) 322-3439

7912 E 31st Ct
Ste 220
Tulsa, OK 74145
Phone (352) 572-5457

7912 E 31st Ct
Ste 120
Tulsa, OK 74145
Phone (918) 663-5538

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1339027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530576000000",
    "number": "1649531484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 S YALE AVE STE 1200",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741363361",
            "telephone_number": "918-488-6045",
            "fax_number": "918-488-6098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 S MAIN ST",
            "city": "SAND SPRINGS",
            "state": "OK",
            "postal_code": "740636509",
            "telephone_number": "918-245-2286",
            "fax_number": "918-241-4366"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "620 N Carriage Pkwy",
            "address_purpose": "LOCATION",
            "city": "Wichita",
            "state": "KS",
            "postal_code": "672084501",
            "country_code": "US",
            "telephone_number": "316-962-3100",
            "fax_number": "316-962-3132",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "140 West 151st. Street South",
            "address_2": "Suite 202",
            "address_purpose": "LOCATION",
            "city": "Glenpool",
            "state": "OK",
            "postal_code": "74033",
            "country_code": "US",
            "telephone_number": "918-321-7400",
            "fax_number": "918-321-7415",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LATIMER",
        "first_name": "ERIN",
        "middle_name": "JENNIFER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-07",
        "last_updated": "2018-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OK",
            "license": "33897",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ERIN",
            "last_name": "KENNY",
            "middle_name": "JENNIFER",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Sand Springs, OK

Sources for this page

Verify at the official NPI Registry.