Timothy A Lattimore, NURSE PRACTITIONER

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

APRN11002945 Issued in FL

Practice address

1594 Kingsley Ave
Orange Park, FL 32073-4546

Phone

(904) 264-8621

NPI assigned

Sep 23, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: timothy.lattimore@hca5.eclinicaldirectplus.com

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.

• Jacksonville Carenow Urgent Care, LLC

  • Urgent Care Clinic/Center
  • Jacksonville, FL
  • NPI 1447771670
  Medicare reassignment NPD
• Memorial Family Practice Associates, LLC

  • Family Medicine Physician
  • Jacksonville, FL
  • NPI 1598869844
  Medicare reassignment NPD
• Memorial Family Practice Associates LLC

  • Family Medicine Physician
  • Jacksonville, FL
  • NPI 1851333108
  NPD (past)

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

{
    "created_epoch": "1569196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569542400000",
    "number": "1699326439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3616 MORNING MEADOW LN",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320737602",
            "telephone_number": "904-655-1153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1594 KINGSLEY AVE",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734546",
            "telephone_number": "904-264-8621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LATTIMORE",
        "first_name": "TIMOTHY",
        "middle_name": "A",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-23",
        "last_updated": "2019-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11002945",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11002945",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lanah W Larson, RN
• Mary St. John Larson, LMT,CMTPT
• Zachary Larson, LMHC
• Paul M. Lasala, C.O.T.A
• Junior Lashley
• Caitlin Laurence
• Adele Lavasseur, LMT
• James Lavin, PTA
• Whitney E. Law, PA
• Alexandra Lawlor, DO, MPH

• Nurse Practitioner in Orange Park, FL
• Providers in Orange Park, FL by specialty
• Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.