Loresa Latham

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

160.003895 Issued in IL

Practice address

221 11TH Ave
Moline, IL 61265-1498

Phone

(309) 757-7744

NPI assigned

Mar 8, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1457395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457395200000",
    "number": "1659732394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 11TH AVE",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612651498",
            "telephone_number": "309-757-7744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 11TH AVE",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612651498",
            "telephone_number": "309-757-7744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LATHAM",
        "first_name": "LORESA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-08",
        "last_updated": "2016-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IL",
            "license": "160.003895",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Scott Alan Lamb, PTA
• Laurie A Lance
• Paul Lappin
• Christopher C Larsen, DMD
• Sharon C Lash, PSY.D.
• Nancy J Lavin, SLP
• Steven J Layer, P.T.
• Lexis Leach, APRN
• Michael R. Leasenby, D.C.
• Rita Joan Ledbetter, CNM

• Physical Therapy Assistant in Moline, IL
• Providers in Moline, IL by specialty
• Physical Therapy Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.