Active NPI
Tami Sue King-Latka, NP
- Adult Health Nurse Practitioner
- Colorado Springs, CO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- APN.0004035
- Practice address
- 1400 E Boulder St Ste 2410
Colorado Springs, CO 80909-5533 - Phone
- (719) 365-6529
- Fax
- (719) 365-5831
- NPI assigned
- Jul 12, 2006
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | 93971 | CO | |
| Adult Health Nurse Practitioner | 363LA2200X | APN.0004035 | CO | Primary |
Addresses
Primary practice location
1400 E Boulder St Ste 2410
Colorado Springs, CO 80909-5533
Mailing address
2695 Rocky Mountain Ave Ste 150
Loveland, CO 80538-9071
Phone (970) 624-4451
Other practice location 1
4050 Briargate Pkwy Ste B1219
Colorado Springs, CO 80920-7815
Phone (719) 365-6529
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9000207730 | Medicaid | CO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 93971 | CO | MD | Adult Health Nurse Practitioner |
| APN.0004035 | CO | MD | Adult Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Poudre Valley Medical Group, LLC | Current | Accepting new patients | |
| Poudre Valley Medical Group, LLC | Current | Accepting new patients |
Locations
4404 Barranca Ln
Castle Rock, CO 80104
Phone (720) 733-5260
4050 Briargate Pkwy
Ste B1220
Colorado Springs, CO 80920
Phone (719) 365-5629
1400 E Boulder St
Ste 2410
Colorado Springs, CO 80909
Phone (719) 365-5629
4050 Briargate Pkwy
Ste B1219
Colorado Springs, CO 80920
Phone (719) 365-6529
2695 Rocky Mountain Ave
Ste 150
Loveland, CO 80538
Phone (970) 624-2412
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.
-
- General Practice Physician
- Loveland, CO
- NPI 1225356868
-
- General Practice Physician
- Loveland, CO
- NPI 1366763260
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152662400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1663632000000",
"number": "1780609727",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2695 ROCKY MOUNTAIN AVE STE 150",
"city": "LOVELAND",
"state": "CO",
"postal_code": "805389071",
"telephone_number": "970-624-4451",
"fax_number": "970-490-4199"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 E BOULDER ST STE 2410",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809095533",
"telephone_number": "719-365-6529",
"fax_number": "719-365-5831"
}
],
"practiceLocations": [
{
"address_1": "4050 Briargate Pkwy Ste B1219",
"address_purpose": "LOCATION",
"city": "Colorado Springs",
"state": "CO",
"postal_code": "809207815",
"country_code": "US",
"telephone_number": "719-365-6529",
"fax_number": "719-365-5831",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KING-LATKA",
"first_name": "TAMI",
"middle_name": "SUE",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-12",
"last_updated": "2022-09-20",
"certification_date": "2022-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "CO",
"license": "93971",
"primary": false
},
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "CO",
"license": "APN.0004035",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9000207730",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Colorado Springs, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.