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MR. RICKY DWAYNE LATHAM MD NPI 1477553139


NPI Information

NPI: 1477553139
Provider Name: MR. RICKY DWAYNE LATHAM, MD
Classification: Internal Medicine - 207RC0000X
Entity Type: Individual

Specialization: Cardiovascular Disease

Organization: BMH INC

PECOS Registration: Yes

Address:
2001 VALENICA DRIVE
SUITE 201
IDAHO FALLS, ID
ZIP 83404
Phone: (208) 524-9400
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MR. Ricky Dwayne Latham, MD is a cardiovascular disease internal medicine in Idaho Falls, ID with 45 years of experience. The provider is an internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. MR. Ricky Dwayne Latham, MD NPI is 1477553139. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: LOUISIANA STATE UNIVERSITY SCHOOL OF MEDICINE IN SHREVEPORT
Graduation Year:1979

The provider's business location address is:

2001 VALENICA DRIVE
SUITE 201
IDAHO FALLS, ID
ZIP 83404
Phone: (208) 524-9400
Fax: (208) 524-9401

The NPI 1477553139 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Ultrasound examination of heart including color-depicted blood flow rate, direction, and valve function (HCPCS:93306)
  • Insertion of catheter in left heart for imaging of blood vessels or grafts and left lower heart (HCPCS:93458)
  • Catheter insertion of stents in major coronary artery or branch, accessed through the skin (HCPCS:92928)
  • Exercise or drug-induced heart and blood vessel stress test with EKG monitoring, physician interpretation and report (HCPCS:93018)
  • Routine EKG using at least 12 leads including interpretation and report (HCPCS:93000)
  • Ultrasound guidance for accessing into blood vessel (HCPCS:76937)
  • Routine electrocardiogram (EKG) using at least 12 leads with interpretation and report (HCPCS:93010)
  • Insertion of new or replacement of permanent pacemaker including upper and lower chamber electrodes (HCPCS:33208)

The enumeration date for this NPI number is 7/26/2005 and was last updated on 2/13/2019.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207RC0000XInternal MedicineCardiovascular DiseaseM6887IDAHONo
2207RC0000XInternal MedicineCardiovascular DiseaseMD170342OREGONYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1000353200MEDICAIDIDAHO
2500680039MEDICAIDOREGON
3000010005099OTHERBLUE SHIELD OF ID S, BS2
4060053550OTHERRAILROAD MEDICARE, RRM
58318842OTHERMEDICAID OF WA, MD-W
61134041OTHERMEDICARE-CIGNA, MC
7DZ692OTHERBLUE CROSS OF ID SE, BC2
80031512OTHERMONTANA MEDICAID, MEM
9M6887OTHERIDAHOID
10000010005099OTHERBLUE SHIELD OF ID, BS
11111489100OTHERWY/EDS CONSULTEC, INC WYM
12DZ692OTHERBLUE CROSS OF IDAHO, BC
13000353200OTHEREDS- MEDICAID, EDS
14111489100OTHERMEDICAID WYOMING, MWY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.