DR. EDWARD E LATHAM JR. (NPI# 1851439988) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851439988 |
| Entity Type | Individual |
| Full Name | DR. EDWARD E LATHAM JR. |
| Credential | PH.D. |
| Practice Address |
404 E Market St Kingsport TN 37660-4828 |
| Practice Telephone | 4233926898 |
| Practice Fax Number | 4233926900 |
| Mailing Telephone | 4233926898 |
| Mailing Fax Number | 4233926900 |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2012-01-24 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103T00000X | Psychologist | P1405 | TN | Behavioral Health & Social Service Providers |
| N | 103TA0400X |
Psychologist Specialization: Addiction (Substance Use Disorder) |
P1405 | TN | Behavioral Health & Social Service Providers |
| N | 103TA0700X |
Psychologist Specialization: Adult Development & Aging |
P1405 | TN | Behavioral Health & Social Service Providers |
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
P1405 | TN | Behavioral Health & Social Service Providers |
| N | 103TP2701X |
Psychologist Specialization: Group Psychotherapy |
P1405 | TN | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | UMWA | 1437005 | 01 |
| TN | BCBSTN-MEDICAL | 4067035 | 01 |
| TN | UNITED HEALTHCARE | 6109533 | 01 |
| TN | BCBS VA | 063454 | 01 |
| TN | AETNA | 4418397 | 01 |
| TN | BCBSTN | 0099539 | 01 |
| TN | VALUE OPTIONS | 132696 | 01 |
| TN | MAGELLAN | 241583000 | 01 |
| TN | PHCS | 9213176 | 01 |
| Street Address |
404 E MARKET ST |
| City | KINGSPORT |
| State | TN |
| Zip Code | 37660-4828 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114069531 | Thomas J Burns | Psychologist | 404 E Market St, Kingsport, TN 37660-4828 | 2007-02-13 |
| 1811035967 | Martha S Rubenstein | Psychologist | 404 E Market St, Kingsport, TN 37660-4828 | 2007-02-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750909891 | Nancy Gober | Pharmacist | Holston Valley Medical Center Inpatient Pharmacy, 130 W Ravine, Kingsport, TN 37660 | 2020-07-06 |
| 1700437621 | Tammy Denise Leblanc | Technician | 125 Lancer Rd, Kingsport, TN 37660 | 2019-09-23 |
| 1831743392 | Independent Physical Therapy | Occupational Therapist | 1704 E. Stone Dr. Ste 120, Kingsport, TN 37660 | 2019-08-01 |
| 1871095315 | Macie Anderson | Nurse Practitioner | 411 Clay St, Kingsport, TN 37660 | 2018-03-01 |
| 1053813527 | Pulitzer Orthodontics, LLC | Dentist | 1200 Pulitzer Place, Kingsport, TN 37660 | 2018-03-01 |
| 1174038749 | Sbh-kingsport | Psychiatric Hospital | 1025 Executive Park Blvd, Kingsport, TN 37660 | 2017-12-05 |
| 1548771447 | Sara B Ball | Registered Nurse | 111 W Stone Dr Ste 240, Kingsport, TN 37660 | 2017-10-18 |
| 1821525361 | Ashley Brook Weems | Nurse Practitioner | Six Sheridan Square Suite 100, Kingsport, TN 37660 | 2017-05-15 |
| 1639625643 | Stephanie H Garris | Nurse Practitioner | 117 W Sevier Ave Ste 120, Kingsport, TN 37660 | 2016-08-30 |
| 1073965679 | Teresa Anne Starke | Physician Assistant | 8 Sheridan Square, Suite 110, Kingsport, TN 37660 | 2016-07-07 |
| Find all providers in zip 37660 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891934675 | Lori Klinger | Psychologist | 2001 E Stonebrook Pl, Kingsport, TN 37660-4000 | 2009-02-18 |
| 1770793556 | David Charles Cantor | Psychologist | 2808 E Center St, Kingsport, TN 37664-2718 | 2007-05-23 |
| 1891876819 | Stephen C Smith | Psychologist | 2035 E Stonebrook Pl, Kingsport, TN 37660-4000 | 2006-10-17 |
| 1487050233 | Natasha Benfield Gouge | Psychologist | 2002 Brookside Dr, Suite 200, Kingsport, TN 37660-4634 | 2014-11-06 |
| 1891750410 | Judy B Millington | Psychologist | 110 E Main St, Kingsport, TN 37660-4212 | 2006-04-18 |
| 1497717508 | Ted W Hagen II | Psychologist | 110 E Main St, Kingsport, TN 37660-4212 | 2006-04-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811597727 | Dorsey Matthew Howard | Psychologist | 315 33rd Ave N, Nashville, TN 37209-3941 | 2020-10-29 |
| 1003422874 | Daniel Diperna | Psychologist | 4205 Hillsboro Pike Ste 301, Nashville, TN 37215-3339 | 2020-09-17 |
| 1073137758 | Stephanie Nicole Zuckerman | Psychologist | Intrepid Street, Bldg. S-771, Millington, TN 38054 | 2020-05-29 |
| 1447873906 | Virtual Adhd Services and Testing | Psychologist | 8935 Magnolia Leaf Cv, Cordova, TN 38018-7413 | 2020-05-19 |
| 1538781679 | David R Richie | Psychologist | 680 Russell Rd, Bolivar, TN 38008-3573 | 2020-05-12 |
| 1710513890 | Elizabeth Katharine Collier Baker | Psychologist | 1800 Volunteer Blvd Fl 2, Knoxville, TN 37996-4522 | 2020-03-20 |
| 1881220697 | Rachel Miller Slough | Psychologist | 801 S Dossett Drive, Johnson City, TN 37614 | 2020-03-13 |
| 1164067518 | Jared Scott Yaw | Psychologist | 907 Maynor St, Nashville, TN 37216-3021 | 2019-11-08 |
| 1972144285 | Lauren Dattilo | Psychologist | 1211 21st Ave S Bldg Suite010, Nashville, TN 37212-2717 | 2019-10-08 |
| 1720635030 | Amy Rebekah Murrell | Psychologist | 8558 Ericson Cv, Cordova, TN 38018-7312 | 2019-08-21 |
| Find all providers with the same taxonomy | ||||
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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.