Craig Larry Lathen, FNP
Individual provider Active NPI Nurse Practitioner · Owyhee, NV
NPI 1962265199 · NPPES record last updated Jan 31, 2024
Key facts
- NPI
- 1962265199
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 55861 (ID)
- Practice address
- 1623 Hospital Loop
Owyhee, NV 89832-1200 - Phone
- (775) 757-2415
- Fax
- (775) 757-3010
- NPI assigned
- Jan 31, 2024
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Shoshone-Paiute Tribes
Practice addresses (Care Compare)
1623 Hospital Loop
Owyhee, NV 89832-1200
Phone (775) 757-2415
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240816000944 | TX | Practitioner - Nurse Practitioner | 6709324106 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Shoshone Paiute Tribes | Current |
Accepting new patients | |
| Shoshone-Paiute Tribes | Current |
Accepting new patients | |
| Shoshone Paiute Tribes | Past | Accepting new patients |
Locations
1623 Hospital Loop
Owyhee, NV 89832
Phone (775) 757-2403
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 55861 | ID | Yes |
Addresses
Primary practice location
1623 Hospital Loop
Owyhee, NV 89832-1200
Mailing address
PO Box 116
Mountain City, NV 89831-0116
Phone (208) 851-2472
Other providers in Owyhee, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 31, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.