LATASHA VICK (NPI# 1669456364) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669456364 |
| Entity Type | Individual |
| Full Name | LATASHA VICK |
| Credential | DDS |
| Practice Address |
2990 Military Ave Baxter Springs KS 66713-2331 |
| Mailing Address |
3011 N Michigan St Pittsburg KS 66762-2546 |
| Practice Telephone | 6208562900 |
| Practice Fax Number | 6208562901 |
| Mailing Telephone | 6202319873 |
| Mailing Fax Number | 6202312808 |
| Enumeration Date | 2005-12-06 |
| Last Update Date | 2013-08-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
61068 | KS | Dental Providers |
| N | 363A00000X | Physician Assistant | 1061723 | OK | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
1061723 | OK | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | 200022980C | 05 | |
| OK | 200022980B | 05 | |
| OK | PA LICENSE | 1061723 | 01 |
| Street Address |
2990 MILITARY AVE |
| City | BAXTER SPRINGS |
| State | KS |
| Zip Code | 66713-2331 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295274462 | David Adams | Social Worker | 2990 Military Ave, Baxter Springs, KS 66713-2331 | 2017-02-21 |
| 1811304348 | Margaret Elizabeth Barnidge | Family Medicine | 2990 Military Ave, Baxter Springs, KS 66713-2331 | 2014-07-16 |
| 1275950537 | Robert Mcelwee | Marriage & Family Therapist | 2990 Military Ave, Baxter Springs, KS 66713-2331 | 2014-03-25 |
| 1265862320 | Sheila Hart | Nurse Practitioner | 2990 Military Ave, Baxter Springs, KS 66713-2331 | 2013-11-26 |
| 1356775696 | Saher Ahmed | Dentist | 2990 Military Ave, Baxter Springs, KS 66713-2331 | 2013-08-22 |
| 1083048342 | Jeanna R Keizer | Dental Hygienist | 2990 Military Ave, Baxter Springs, KS 66713-2331 | 2013-08-22 |
| 1861826133 | Cindy M Smith | Dental Hygienist | 2990 Military Ave, Baxter Springs, KS 66713-2331 | 2013-08-22 |
| 1205275559 | Jamie D Lundy | Dentist | 2990 Military Ave, Baxter Springs, KS 66713-2331 | 2013-06-20 |
| 1942550579 | Jennifer J Adkins | Nurse Practitioner | 2990 Military Ave, Baxter Springs, KS 66713-2331 | 2012-09-11 |
| 1548579857 | Alison L Eaton | Nurse Practitioner | 2990 Military Ave, Baxter Springs, KS 66713-2331 | 2010-10-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144266859 | James C Eaton | Family Medicine | 322 E 11th St, Baxter Springs, KS 66713 | 2006-06-21 |
| 1376637157 | Cherokee County Ambulance Assoc. Dist. IIi | Ambulance | 311 Military Avenue, Baxter Springs, KS 66713-0137 | 2006-10-03 |
| 1629465109 | Monarch Pharmacy | Pharmacy | 1111 Military Ave, Baxter Springs, KS 66713-1509 | 2015-04-22 |
| 1154875714 | Kelly Barnes | Pharmacist | 1111 Military Ave, Baxter Springs, KS 66713-1509 | 2016-08-11 |
| 1457392888 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 1000 Military Ave, Baxter Springs, KS 66713-1547 | 2006-06-09 |
| 1417569930 | Carissa Christie | Pharmacist | 1000 Military Ave, Baxter Springs, KS 66713-1547 | 2020-08-17 |
| 1588601843 | Tyson L. Burden | Internal Medicine | 445 E 10th St, Baxter Springs, KS 66713-1614 | 2006-06-02 |
| 1063925303 | Legacy Living | Custodial Care Facility | 445 E 10th St, Baxter Springs, KS 66713-1614 | 2017-11-08 |
| 1134437411 | Crystal Marie Taylor | Nurse Practitioner | 445 E 10th St, Baxter Springs, KS 66713-1614 | 2010-09-20 |
| 1366680126 | Burden Medical Clinic LLC | Clinic/Center | 445 E 10th St, Baxter Springs, KS 66713-1614 | 2009-01-30 |
| Find all providers in zip 66713 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356775696 | Saher Ahmed | Dentist | 2990 Military Ave, Baxter Springs, KS 66713-2331 | 2013-08-22 |
| 1205275559 | Jamie D Lundy | Dentist | 2990 Military Ave, Baxter Springs, KS 66713-2331 | 2013-06-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780290205 | Centurion/mhm/centene | Dentist | 11130 Rd E, Norton, KS 67654 | 2020-09-21 |
| 1023620523 | Shibin Yu | Dentist | 13705 Manor, Leawood, KS 66224-4523 | 2020-08-18 |
| 1770192767 | Mackenzie Colson | Dentist | 5611 W 134th Ter Apt 1718, Leawood, KS 66209-4060 | 2020-07-27 |
| 1104434463 | Vaidehi Trivedi | Dentist | 10818 Parallel Pkwy # Ks, Kansas City, KS 66109-3649 | 2020-07-22 |
| 1326656117 | Joel David Piper | Dentist | 10840 Shawnee Mission Pkwy, Shawnee, KS 66203-3512 | 2020-07-17 |
| 1184241044 | Celsus LLC | Dentist | 3110 Nieder Rd, Lawrence, KS 66047-1950 | 2020-06-26 |
| 1609405398 | Upcare Dental Olathe LLC | Dentist | 790 N Ridgeview Rd, Olathe, KS 66061-2900 | 2020-04-03 |
| 1144852302 | Rosenberg Dentistry: Joe Rosenberg Dds. Pa | Dentist | 1037 Sheridan Suite D, Great Bend, KS 67530 | 2020-02-06 |
| 1063052777 | Threemondds LLC | Dentist | 7524 State Ave, Kansas City, KS 66112-2816 | 2020-01-10 |
| 1427606706 | Nathan A Laskowski | Dentist | 3507 S 4th St. Trafficway, Leavenworth, KS 66048 | 2019-08-29 |
| Find all providers with the same taxonomy | ||||
| City | BAXTER SPRINGS |
| Zip Code | 66713 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.