Latricia Dail Chastain, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

5005452 Issued in NC

Practice address

2334 41St St
Wilmington, NC 28403-5502

Phone

(910) 815-3122

NPI assigned

Dec 9, 2011

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 2

Other names 1

• Latricia Mae Dail Former name

Medicare fee-for-service enrollment

Enrolled in NC

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

Specialty

Nurse Practitioner

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Liberty Healthcare Group LLCGroup PAC ID 4587574355, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Liberty Healthcare Group, LLC

  • Case Management Agency
  • Wilmington, NC
  • NPI 1629217856
  Medicare reassignment Care Compare group NPD
• Liberty Healthcare Group LLC

  • Skilled Nursing Facility
  • Falcon, NC
  • NPI 1912040379
  NPD

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

{
    "created_epoch": "1323388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738195200000",
    "number": "1821366436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2334 41ST ST",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284035502",
            "telephone_number": "910-815-3122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2334 41ST ST",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284035502",
            "telephone_number": "910-815-3122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHASTAIN",
        "first_name": "LATRICIA",
        "middle_name": "DAIL",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-09",
        "last_updated": "2025-01-30",
        "certification_date": "2025-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5005452",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1821366436",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP2519",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LATRICIA",
            "last_name": "DAIL",
            "middle_name": "MAE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Jessica Mary Chase, DO
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• Arden Grace Chaucer-Sword
• Fahad Chaudhary, MD
• John B Chauvin, DC
• Robin Chavara

• Family Nurse Practitioner in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Family Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.