Annmarie Asis Latham, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

25MP00306200 Issued in NJ

Practice address

499 Beckett Rd
Suite 201
Logan Township, NJ 08085-1766

Phone

(856) 467-6400

Fax

(856) 467-1033

NPI assigned

Apr 23, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Seretiscare Inc.

  • Primary Care Clinic/Center
  • Logan Township, NJ
  • NPI 1487758165
  Medicare reassignment

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

{
    "created_epoch": "1366675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380844800000",
    "number": "1982048849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "499 BECKETT RD",
            "address_2": "SUITE 201",
            "city": "LOGAN TOWNSHIP",
            "state": "NJ",
            "postal_code": "080851766",
            "telephone_number": "856-467-6400",
            "fax_number": "856-467-1033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "499 BECKETT RD",
            "address_2": "SUITE 201",
            "city": "LOGAN TOWNSHIP",
            "state": "NJ",
            "postal_code": "080851766",
            "telephone_number": "856-467-6400",
            "fax_number": "856-467-1033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LATHAM",
        "first_name": "ANNMARIE",
        "middle_name": "ASIS",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-23",
        "last_updated": "2013-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00306200",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA056009",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Holistic Healing Counseling Services
• Allison Jessar, PSYD
• Harshila Kakkilaya, MD
• Christian Robert Klumpp
• William Martin Kozuch, D.D.S.
• Logan Township School District
• Jan P Long, MSN ANP-C
• Natalie J Lowe
• Mark Giorno DMD & Associates PA
• Erin M Meyers, RN

• Physician Assistant in Logan Township, NJ
• Providers in Logan Township, NJ by specialty
• Physician Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2013; 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.