Mikayla Mary Latham, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

50111833 Issued in NC

Practice address

1302 Lexington Ave
Thomasville, NC 27360-3419

Phone

(336) 475-6139

Fax

(336) 475-3331

NPI assigned

Nov 13, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mikayla Mary Birthrong Professional name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NC

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

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Novant Health Medical Group, LLC

  • Neurology with Special Qualifications in Child Neurology Physician
  • Charlotte, NC
  • NPI 1366409492
  Medicare reassignment Care Compare group NPD
• Novant Health Medical Group, LLC

  • Obstetrics & Gynecology Physician
  • Matthews, NC
  • NPI 1386506137
  NPD
• Novant Medical Group Inc

  • Urology Physician
  • Winston Salem, NC
  • NPI 1992161665
  NPD
• Novant Health Medical Group, LLC

  • Internal Medicine Physician
  • Charlotte, NC
  • NPI 1134841802
  NPD (past)

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

{
    "created_epoch": "1542067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724630400000",
    "number": "1982172573",
    "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": "1302 LEXINGTON AVE",
            "city": "THOMASVILLE",
            "state": "NC",
            "postal_code": "273603419",
            "telephone_number": "336-475-6139",
            "fax_number": "336-475-3331"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2909 Maplewood Ave",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271034009",
            "country_code": "US",
            "telephone_number": "336-277-0340",
            "fax_number": "336-794-9411",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LATHAM",
        "first_name": "MIKAYLA",
        "middle_name": "MARY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-13",
        "last_updated": "2024-08-26",
        "certification_date": "2024-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "50111833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mlatham177246@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "2909 Maplewood Ave",
            "city": "Winston Salem",
            "state": "NC",
            "country_code": "US",
            "postal_code": "271034009",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MIKAYLA",
            "last_name": "BIRTHRONG",
            "middle_name": "MARY",
            "credential": "NP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Eric D Lance, M.D.
• Darian Maurice Laneave, M.D.
• Devin Lanier
• Michael Maxell Lanning, DDS
• Larry Jacob Darr
• Jinoo Tommy Lee, M.D.
• Carolyn Arlette Leitzell, FNP
• Ureh Nnenna Lekwauwa, MD
• Jeffrey Wayne Lemons, P.T.
• Robert William Lena, PHARMD

• Nurse Practitioner in Thomasville, NC
• Providers in Thomasville, NC by specialty
• Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.