Individual provider Active NPI

Jeffrey F Latham, MD

  • Cardiovascular Disease Physician
  • Woonsocket, RI
National Provider Identifier
1891793196
Registry record updated Dec 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
MD05050 Issued in RI
Practice address
68 Cumberland St
Sutie 103
Woonsocket, RI 02895-3323
Phone
(401) 762-3838
Fax
(401) 762-8252
NPI assigned
Jul 11, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X MD05050 RI Primary

Addresses

Primary practice location

68 Cumberland St
Sutie 103
Woonsocket, RI 02895-3323

Mailing address

68 Cumberland St
Sutie 103
Woonsocket, RI 02895-3323
Phone (401) 762-3838

Other identifiers 1

IdentifierTypeStateIssuer
7003889MedicaidRI

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD05050RIMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rhode Island Cardiovascular Group Cardiovascular Disease Past Accepting new patients

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": "1121040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197244800000",
    "number": "1891793196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "68 CUMBERLAND ST",
            "address_2": "SUTIE 103",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "028953323",
            "telephone_number": "401-762-3838",
            "fax_number": "401-762-8252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "68 CUMBERLAND ST",
            "address_2": "SUTIE 103",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "028953323",
            "telephone_number": "401-762-3838",
            "fax_number": "401-762-8252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LATHAM",
        "first_name": "JEFFREY",
        "middle_name": "F",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-11",
        "last_updated": "2007-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "RI",
            "license": "MD05050",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7003889",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woonsocket, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2007; 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.