Individual provider Active NPI

Latoya Maria Beauchamp, NP

  • Nurse Practitioner
  • Decatur, GA
National Provider Identifier
1750040788
Registry record updated Oct 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN-NP219588 Issued in GA
Practice address
2124 Candler Rd
Decatur, GA 30032-5572
Phone
(404) 836-0272
NPI assigned
Dec 17, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN-NP219588 GA Primary

Addresses

Primary practice location

2124 Candler Rd
Decatur, GA 30032-5572

Mailing address

501 Lapalco Blvd
Gretna, LA 70056-7336
Phone (504) 393-4376

Other practice location 1

501 Lapalco Blvd
Gretna, LA 70056-7336
Phone (504) 393-4376

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20230329000207 GA Practitioner - Nurse Practitioner 6800280801 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN-NP219588GAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Jencare Neighborhood Medical Center West End, LLC CurrentSince Apr 1, 2023 Accepting new patients
PMR Georgia Holding, LLC CurrentSince Apr 1, 2023 Accepting new patients

Locations

1395 NW 167th St
Miami Gardens, FL 33169
Phone (305) 831-4760

1325 Ralph David Abernathy Blvd SW
Atlanta, GA 30310
Phone (404) 419-0184

2124 Candler Rd
Decatur, GA 30032
Phone (404) 836-0272

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1639699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759968000000",
    "number": "1750040788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 LAPALCO BLVD",
            "city": "GRETNA",
            "state": "LA",
            "postal_code": "700567336",
            "telephone_number": "504-393-4376",
            "fax_number": "504-930-4307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2124 CANDLER RD",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300325572",
            "telephone_number": "404-836-0272"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "501 Lapalco Blvd",
            "address_purpose": "LOCATION",
            "city": "Gretna",
            "state": "LA",
            "postal_code": "700567336",
            "country_code": "US",
            "telephone_number": "504-393-4376",
            "fax_number": "504-930-4307",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BEAUCHAMP",
        "first_name": "LATOYA",
        "middle_name": "MARIA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-17",
        "last_updated": "2025-10-09",
        "certification_date": "2025-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "APRN-NP219588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

Verify at the official NPI Registry.