Individual provider Active NPI

Latasha Reid

  • Family Nurse Practitioner
  • Louisville, KY
National Provider Identifier
1992210165
Registry record updated Aug 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3012355 Issued in KY
Practice address
8019 Dixie Hwy Ste 101
Louisville, KY 40258-1303
Phone
(502) 333-3121
Fax
(502) 531-9538
NPI assigned
Dec 8, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 112721 KY
Family Nurse Practitioner 363LF0000X 3012355 KY Primary

Addresses

Primary practice location

8019 Dixie Hwy Ste 101
Louisville, KY 40258-1303

Mailing address

8019 Dixie Hwy Ste 101
Louisville, KY 40258-1303
Phone (502) 333-3121

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, KY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190624001003 IN Practitioner - Nurse Practitioner 4688908759 Reassigns benefits to 1 organization
I20190703000599 KY Practitioner - Nurse Practitioner 4688908759 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
112721KYMDRegistered Nurse
3012355KYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
PMR Ky Holding, LLC CurrentSince Sep 1, 2023 Accepting new patients

Locations

2406 W Broadway
Louisville, KY 40211
Phone (502) 775-1211

8019 Dixie Hwy
Ste 101
Louisville, KY 40258
Phone (502) 333-3121

Organizations & group practices 2

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.

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
May accept Medicare assignment
Group practices
Bluegrass Kidney Consultants PSC 19 clinicians
PMR Ky Holding LLC 7 clinicians

Practice addresses (Care Compare)

721 S Preston St
Louisville, KY 40203-2319
Phone (502) 583-1799

8019 Dixie Hwy
Suite 101
Louisville, KY 40258-1303
Phone (502) 333-3121

NPI Registry JSON

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

{
    "created_epoch": "1512691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692057600000",
    "number": "1992210165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8019 DIXIE HWY STE 101",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402581303",
            "telephone_number": "502-333-3121",
            "fax_number": "502-531-9538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8019 DIXIE HWY STE 101",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402581303",
            "telephone_number": "502-333-3121",
            "fax_number": "502-531-9538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REID",
        "first_name": "LATASHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-08",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "KY",
            "license": "112721",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3012355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.