Individual provider Active NPI

Kelmira Latham, MS, CCC-SLP

  • Speech-Language Pathologist
  • Greenville, NC
National Provider Identifier
1770646572
Registry record updated Apr 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
6412 Issued in NC
Practice address
3906 Southampton CT
Greenville, NC 27834-7671
Phone
(252) 717-6769
Fax
(252) 756-4614
NPI assigned
Dec 19, 2006
Last updated
Apr 16, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 6412 NC Primary

Addresses

Primary practice location

3906 Southampton CT
Greenville, NC 27834-7671

Mailing address

3906 Southampton CT
Greenville, NC 27834-7671
Phone (252) 717-6769

Other identifiers 1

IdentifierTypeStateIssuer
7412433MedicaidNC

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
Master of Science

State licenses

LicenseStateTypeSpecialty
6412NCMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Kelmira Lathams Readysetgo Speechinc Speech-Language Pathologist Past Accepting new patients
Ready Set Go Speech Inc Speech-Language Pathologist Past Accepting new patients

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

NPI Registry JSON

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366070400000",
    "number": "1770646572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3906 SOUTHAMPTON CT",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278347671",
            "telephone_number": "252-717-6769",
            "fax_number": "252-756-4614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3906 SOUTHAMPTON CT",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278347671",
            "telephone_number": "252-717-6769",
            "fax_number": "252-756-4614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LATHAM",
        "first_name": "KELMIRA",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-19",
        "last_updated": "2013-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "6412",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7412433",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2013; 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.