Individual provider Active NPI

Babak Latefi, MD

  • Student in an Organized Health Care Education/Training Program
  • Evansville, IN
National Provider Identifier
1760065809
Registry record updated Dec 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1110 Professional Blvd Ste a
Evansville, IN 47714-8000
Phone
(845) 397-7787
NPI assigned
May 5, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

1110 Professional Blvd Ste a
Evansville, IN 47714-8000

Mailing address

5444 E Indiana St Ste 109
Evansville, IN 47715-2857
Phone (845) 397-7787

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
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Better Behavioral Kentucky LLC Current Accepting new patients
Virtual Consult MD LLC CurrentSince May 1, 2021 Accepting new patients
Better Behavioral Indiana LLC Current Accepting new patients
Better Behavioral Georgia LLC Current Accepting new patients

Locations

1110 Professional Blvd
#A
Evansville, IN 47714
Phone (845) 397-7787

5444 E Indiana St
Evansville, IN 47715
Phone (812) 435-9099

Organizations & group practices 4

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": "1620172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703030400000",
    "number": "1760065809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5444 E INDIANA ST STE 109",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477152857",
            "telephone_number": "845-397-7787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 PROFESSIONAL BLVD STE A",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477148000",
            "telephone_number": "845-397-7787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LATEFI",
        "first_name": "BABAK",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-05-05",
        "last_updated": "2023-12-20",
        "certification_date": "2023-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.