Vicki C Latham, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

OK725 Issued in OK

Practice address

608 S Hester St
Stillwater, OK 74074-4516

Phone

(405) 377-8000

Fax

(405) 377-8040

NPI assigned

Apr 20, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Vicki Ann Campbell Former name

Medicare fee-for-service enrollment

Enrolled in OK

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: vicki.latham.p4@direct.smc.nextgenshare.com

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.

• Associates of Medicine/John D Williams,MD,PLLC

  • Internal Medicine Physician
  • Stillwater, OK
  • NPI 1770733917
  Medicare reassignment

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

{
    "created_epoch": "1145491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257379200000",
    "number": "1790740769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "608 S HESTER ST",
            "city": "STILLWATER",
            "state": "OK",
            "postal_code": "740744516",
            "telephone_number": "405-377-8000",
            "fax_number": "405-377-8040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "608 S HESTER ST",
            "city": "STILLWATER",
            "state": "OK",
            "postal_code": "740744516",
            "telephone_number": "405-377-8000",
            "fax_number": "405-377-8040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LATHAM",
        "first_name": "VICKI",
        "middle_name": "C",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-20",
        "last_updated": "2009-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "OK725",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200235260A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VICKI",
            "last_name": "CAMPBELL",
            "middle_name": "ANN",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kylie Large, COTA
• Denise Larimore, DPH
• Savanna Larson
• Timothy Ryan Larson
• Sadah Elaine Lasich, ED.S.
• Jennifer Lauvetz-Enmeier, DDS
• Robert J Lauvetz, M.D.
• Robert William Lauvetz, M.D.
• Sandra Lynn Laver
• Rachael M Lawler

• Physician Assistant in Stillwater, OK
• Providers in Stillwater, OK by specialty
• Physician Assistant in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2009; 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.

Verify at the official NPI Registry.