Active NPI
Marc Travis Latta, PA-C
- Physician Assistant
- Newark, DE
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 0010-13626
- Practice address
- 4755 Ogletown Stanton Rd
Suite 1E50
Newark, DE 19718-2200 - Phone
- (302) 733-1980
- Fax
- (302) 733-1986
- NPI assigned
- Sep 22, 2006
- Last updated
- Dec 19, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 0110001154 | VA | |
| Physician Assistant | 363A00000X | C5-0001013 | DE | |
| Physician Assistant | 363A00000X | 0010-13626 | NC | Primary |
Addresses
Primary practice location
4755 Ogletown Stanton Rd
Suite 1E50
Newark, DE 19718-2200
Mailing address
200 Hygeia Dr
Suite 2300
Newark, DE 19713-2049
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DE, NC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
4755 Ogletown Stanton Rd
Newark, DE 19718-2200
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Novant Medical Group, Inc. | Current | Accepting new patients | |
| Christiana Care Health Services, Inc | Current | Accepting new patients | |
| Novant Health Medical Group, LLC | Current | Accepting new patients | |
| Moses Cone Medical Services, Inc. | Current | Accepting new patients | |
| Christiana Care Health Services Inc | Current | Accepting new patients | |
| Novant Medical Group, Inc. | Past | Accepting new patients |
Locations
200 Hygeia Dr
Ste 2300
Newark, DE 19713
Phone (302) 623-7362
4755 Ogletown Stanton Rd
#1E50
Newark, DE 19718
Phone (302) 733-1980
4755 Ogletown Stanton Rd
Ste 1E50
Newark, DE 19718
Phone (302) 733-1980
1401 Foulk Rd
Ste 100B
Wilmington, DE 19803
Phone (302) 320-9440
1918 Randolph Rd
Ste 580
Charlotte, NC 28207
Phone (704) 333-9113
1126 N Church St
Ste 300
Greensboro, NC 27401
Phone (336) 547-1700
300 E Wendover Ave
Greensboro, NC 27401
Phone (336) 663-5205
5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441
940 Golf House Ct E
Whitsett, NC 27377
Phone (336) 449-9848
2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300
Interoperability endpoints
- mlatta1631698@direct.novanthealth.org
Organizations & group practices 9
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.
-
dba CCHS Pmri
- Endocrinology, Diabetes & Metabolism Physician
- Wilmington, DE
- NPI 1770568107
-
- Internal Medicine Physician
- Greensboro, NC
- NPI 1427095249
-
dba Novant Health Pediatric Neurology & Sleep
- Neurology with Special Qualifications in Child Neurology Physician
- Charlotte, NC
- NPI 1366409492
-
dba CCHS Cardiac Surgery
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- Newark, DE
- NPI 1275615643
-
dba CCHS Concord - Neurology
- Neurology Physician
- Chadds Ford, PA
- NPI 1881228484
-
dba Western Rockingham Family Medicine
- Family Medicine Physician
- Madison, NC
- NPI 1629376363
-
dba Novant Health Elizabeth OB/GYN
- Obstetrics & Gynecology Physician
- Matthews, NC
- NPI 1386506137
-
dba Novant Health Diabetes & Endocrinology
- Family Medicine Physician
- Hendersonville, NC
- NPI 1124892765
-
dba Mid Carolina Cardiology
- Interventional Cardiology Physician
- Charlotte, NC
- NPI 1205836434
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Christiana Care
- General Acute Care Hospital
- Wilmington, DE
- NPI 1134194038
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158883200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1734566400000",
"number": "1700985769",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 HYGEIA DR",
"address_2": "SUITE 2300",
"city": "NEWARK",
"state": "DE",
"postal_code": "197132049"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4755 OGLETOWN STANTON RD",
"address_2": "SUITE 1E50",
"city": "NEWARK",
"state": "DE",
"postal_code": "197182200",
"telephone_number": "302-733-1980",
"fax_number": "302-733-1986"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LATTA",
"first_name": "MARC",
"middle_name": "TRAVIS",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-22",
"last_updated": "2024-12-19",
"certification_date": "2024-12-19",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "VA",
"license": "0110001154",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "DE",
"license": "C5-0001013",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NC",
"license": "0010-13626",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Newark, DE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2024; 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.
- 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.