Individual provider Active NPI

Lataya Toqwue Whitaker, F.N.P-BC

  • Family Nurse Practitioner
  • Stafford, VA
National Provider Identifier
1780124362
Registry record updated Mar 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024174590 Issued in VA
Practice address
60 Prosperity LN
Stafford, VA 22556-4605
Phone
(540) 658-2811
NPI assigned
Mar 2, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0024174590 VA Primary

Addresses

Primary practice location

60 Prosperity LN
Stafford, VA 22556-4605

Mailing address

5000 Cox Rd
Glen Allen, VA 23060-9263
Phone (804) 968-5700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20170524002279 VA Practitioner - Nurse Practitioner 5294012365 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0024174590VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Thrive Holistic Healing LLC CurrentSince Aug 1, 2022 Accepting new patients

Locations

2761 Richmond Hwy
Ste 207
Stafford, VA 22554
Phone (571) 535-7255

Organizations & group practices 1

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": "1488412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521676800000",
    "number": "1780124362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 COX RD",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230609263",
            "telephone_number": "804-968-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 PROSPERITY LN",
            "city": "STAFFORD",
            "state": "VA",
            "postal_code": "225564605",
            "telephone_number": "540-658-2811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITAKER",
        "first_name": "LATAYA",
        "middle_name": "TOQWUE",
        "credential": "F.N.P-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-02",
        "last_updated": "2018-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024174590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stafford, VA

Sources for this page

Verify at the official NPI Registry.