Individual provider Active NPI

Christopher D Latham

  • Certified Registered Nurse Anesthetist
  • Kingsport, TN
National Provider Identifier
1699818310
Registry record updated Sep 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
APN12372 Issued in TN
Practice address
10415 Wallace Alley St
Kingsport, TN 37663-3936
Phone
(423) 390-0451
NPI assigned
Feb 14, 2007
Last updated
Sep 2, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RN133314 TN
Certified Registered Nurse Anesthetist 367500000X APN12372 TN Primary

Addresses

Primary practice location

10415 Wallace Alley St
Kingsport, TN 37663-3936

Mailing address

PO Box 896138
Charlotte, NC 28289-6138
Phone (423) 639-0941

Other practice location 1

1104 Tusculum Blvd
Suite 114
Greeneville, TN 37745-4091
Phone (833) 500-9914

Other identifiers 3

IdentifierTypeStateIssuer
P00002184OtherTNRAILROAD MEDICARE
3346750MedicaidTN
4295630OtherTNBC/BS OF TN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070519000016 TN Practitioner - Certified Registered Nurse Anesthetist (Crna) 8921105321 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Paragon Anesthesia PCGroup PAC ID 8921044744, 214 clinicians

Practice addresses (Care Compare)

1 Medical Park Blvd
Bristol, TN 37620-7430
Phone (423) 390-0451

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
12372TNMDDentist
30428TNMDObstetrics & Gynecology Physician
APN12372TNMDCertified Registered Nurse Anesthetist
RN133314TNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Paragon Anesthesia PC Nurse Anesthetist, Certified Registered CurrentSince Mar 1, 2025 Accepting new patients
Greeneville Anesthesia Services Nurse Anesthetist, Certified Registered CurrentSince May 31, 2011 Accepting new patients
East Tennessee Ambulatory Surgery Center LLC CurrentSince Mar 1, 2025 Accepting new patients

Locations

1 Medical Park Blvd
Bristol, TN 37620
Phone (423) 390-0451

1104 Tusculum Blvd
Ste 114
Greeneville, TN 37745
Phone (833) 500-9914

401 Takoma Ave
Greeneville, TN 37743
Phone (423) 639-3151

10415 Wallace Alley St
Kingsport, TN 37663
Phone 4233900451 ext. 00451

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756771200000",
    "number": "1699818310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 896138",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282896138",
            "telephone_number": "423-639-0941",
            "fax_number": "423-638-3401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10415 WALLACE ALLEY ST",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376633936",
            "telephone_number": "423-390-0451"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1104 Tusculum Blvd",
            "address_2": "Suite 114",
            "address_purpose": "LOCATION",
            "city": "Greeneville",
            "state": "TN",
            "postal_code": "377454091",
            "country_code": "US",
            "telephone_number": "833-500-9914",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LATHAM",
        "first_name": "CHRISTOPHER",
        "middle_name": "D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-14",
        "last_updated": "2025-09-02",
        "certification_date": "2025-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "RN133314",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "APN12372",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00002184",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3346750",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS OF TN",
            "identifier": "4295630",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingsport, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.