NPIMap

Individual provider Active NPI

Latora Williams, MD

  • Family Medicine Physician
  • Jackson, GA
National Provider Identifier
1982166757
Registry record updated Jun 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
11470 Issued in GA
Practice address
1502 W 3Rd St
Jackson, GA 30233-1979
Phone
(770) 914-0116
NPI assigned
Apr 2, 2019
Last updated
Jun 23, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 11470 GA Primary

Addresses

Primary practice location

1502 W 3Rd St
Jackson, GA 30233-1979

Mailing address

3333 Riverwood Pkwy SE Ste 250
Atlanta, GA 30339-3304
Phone (770) 914-0116

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230607002055 GA Practitioner - Family Practice 1951638485 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aylo Health, LLCGroup PAC ID 8022901925, 112 clinicians
Houston Hospitals IncGroup PAC ID 4284797580, 27 clinicians

Practice addresses (Care Compare)

1502 W 3Rd St
Suite a
Jackson, GA 30233-1979
Phone (770) 914-0116

233 N Houston Rd
Suite 140a
Warner Robins, GA 31093-3023
Phone (478) 975-6720

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
11470GAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Aylo Health, LLC Family Medicine CurrentSince Jul 1, 2023 Accepting new patients
Aylo Health, LLC CurrentSince Jul 1, 2023 Accepting new patients
Houston Hospitals Inc CurrentSince Jul 13, 2023 Accepting new patients
Houston Hospitals Inc CurrentSince Jul 13, 2023 Accepting new patients
The Medical Center of Central Georgia Inc Past Accepting new patients
Health Services of Central Georgia, Inc Family Medicine PastSince Aug 1, 2013 Accepting new patients
Aylo Health, LLC Family Medicine Past Accepting new patients
Aylo Health, LLC Family Medicine Past Accepting new patients
Aylo Health, LLC Past Accepting new patients

Locations

3333 Riverwood Pkwy SE
Ste 250
Atlanta, GA 30339
Phone (770) 914-0016

520 GA Highway 247 S
Ste 501
Bonaire, GA 31005
Phone (478) 352-7110

1101 Nortec Dr SE
Conyers, GA 30013
Phone (678) 374-7514

211 Fairview Rd
Ellenwood, GA 30294
Phone (678) 289-6747

1058 Bear Creek Blvd
Hampton, GA 30228
Phone (770) 707-0808

1502 W 3rd St
Ste A
Jackson, GA 30233
Phone (678) 774-0430

1118 GA Highway 96
Kathleen, GA 31047
Phone (478) 922-4281

3758 Highway 42 S
Locust Grove, GA 30248
Phone (678) 561-9430

3758 Highway 42 S
Ste 200
Locust Grove, GA 30248
Phone (678) 374-7514

50 Kelly Rd
Ste 200
McDonough, GA 30253
Phone (770) 957-1887

65 Old Jackson Rd
McDonough, GA 30252
Phone (678) 490-0080

1100 Hospital Dr
Stockbridge, GA 30281
Phone (678) 432-6161

1240 Eagles Landing Pkwy
Ste 110
Stockbridge, GA 30281
Phone (770) 389-3855

145 Eagles Walk
Ste A
Stockbridge, GA 30281
Phone (770) 389-3855

1601 Watson Blvd
Warner Robins, GA 31093
Phone (478) 322-5155

233 N Houston Rd
Ste 140A
Warner Robins, GA 31093
Phone (478) 923-2843

Interoperability endpoints

  • Direct secure messaging: latora.williams@elfp.eclinicaldirectplus.com

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1554163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687478400000",
    "number": "1982166757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 RIVERWOOD PKWY SE STE 250",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303393304",
            "telephone_number": "770-914-0116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1502 W 3RD ST",
            "city": "JACKSON",
            "state": "GA",
            "postal_code": "302331979",
            "telephone_number": "770-914-0116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "LATORA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-02",
        "last_updated": "2023-06-23",
        "certification_date": "2023-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "11470",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, GA

Sources for this page

Verify at the official NPI Registry.