Individual provider Active NPI

Harold Frank Latta, MD

  • Pediatrics Physician
  • Winston Salem, NC
National Provider Identifier
1922073451
Registry record updated Jan 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
33540 Issued in NC
Practice address
1350 Whitaker Ridge Dr
Winston Salem, NC 27106-4966
Phone
(336) 718-8000
Fax
(336) 718-8011
NPI assigned
Feb 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 33540 NC Primary

Addresses

Primary practice location

1350 Whitaker Ridge Dr
Winston Salem, NC 27106-4966

Mailing address

PO Box 60447
Charlotte, NC 28260-0447

Other identifiers 1

IdentifierTypeStateIssuer
8951142MedicaidNC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address hlatta18942@direct.novanthealth.org

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
33540NCMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group LLC Pediatrics CurrentSince May 29, 2023 Accepting new patients
Novant Health Medical Group, LLC CurrentSince May 29, 2023 Accepting new patients

Locations

517 S Sharon Amity Rd
Charlotte, NC 28211
Phone (704) 384-1406

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

1350 Whitaker Ridge Dr
Winston Salem, NC 27106
Phone (336) 718-8000

Organizations & group practices 3

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": "1140393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643328000000",
    "number": "1922073451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 WHITAKER RIDGE DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271064966",
            "telephone_number": "336-718-8000",
            "fax_number": "336-718-8011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LATTA",
        "first_name": "HAROLD",
        "middle_name": "FRANK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-20",
        "last_updated": "2022-01-28",
        "certification_date": "2022-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "33540",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8951142",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hlatta18942@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "1350 Whitaker Ridge Dr",
            "city": "Winston Salem",
            "state": "NC",
            "country_code": "US",
            "postal_code": "271064966",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2022; 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.