Active NPI
Sydney Latham
- Occupational Therapy Assistant
- Washington, NC
National Provider Identifier
1730834334
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 11659
- Practice address
- 250 Lovers LN
Washington, NC 27889-3436 - Phone
- (252) 975-1636
- NPI assigned
- Feb 14, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 11659 | NC | Primary |
Addresses
Primary practice location
250 Lovers LN
Washington, NC 27889-3436
Mailing address
5587 NC Highway 99 N
Pantego, NC 27860-9783
Phone (125) 294-3807
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11659 | NC | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1644796800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1644796800000",
"number": "1730834334",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5587 NC HIGHWAY 99 N",
"city": "PANTEGO",
"state": "NC",
"postal_code": "278609783",
"telephone_number": "125-294-3807"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "250 LOVERS LN",
"city": "WASHINGTON",
"state": "NC",
"postal_code": "278893436",
"telephone_number": "252-975-1636"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LATHAM",
"first_name": "SYDNEY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-02-14",
"last_updated": "2022-02-14",
"certification_date": "2022-02-14",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "NC",
"license": "11659",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Washington, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.