MR. RICKY DWAYNE LATHAM MD NPI 1477553139

NPI Information

  • NPI: 1477553139
  • Provider Name: MR. RICKY DWAYNE LATHAM, MD
  • Classification: Internal Medicine - 207RC0000X
  • Specialization: Cardiovascular Disease
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 2001 VALENICA DRIVE
    SUITE 201
    IDAHO FALLS, ID
    ZIP 83404
  • Phone: (208) 524-9400

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NPI Details

MR. Ricky Dwayne Latham, MD is a cardiovascular disease internal medicine in Idaho Falls, ID with 47 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.

  • Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only (HCPCS:93010)
  • Ultrasound of heart with color-depicted blood flow, rate, direction and valve function (HCPCS:93306)
  • Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only (HCPCS:93010)
  • Established patient office or other outpatient visit, 30-39 minutes (HCPCS:99214)
  • Exercise or drug-induced heart stress test with electrocardiogram (ecg) with review by physician (HCPCS:93018)
  • Nuclear medicine studies of heart muscle at rest and with stress and spect (HCPCS:78452)
  • Ultrasound of heart with color-depicted blood flow, rate, direction and valve function (HCPCS:93306)
  • New patient office or other outpatient visit, 45-59 minutes (HCPCS:99204)
  • Exercise or drug-induced heart stress test with electrocardiogram (ecg) with review by physician (HCPCS:93018)
  • Established patient office or other outpatient visit, 20-29 minutes (HCPCS:99213)
  • Nuclear medicine studies of heart muscle at rest and with stress and spect (HCPCS:78452)
  • Electrocardiogram (ecg) 2-day continuous with review by health care professional (HCPCS:93227)
  • Ultrasound of both sides of head and neck blood flow (HCPCS:93880)
  • Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report (HCPCS:93000)
  • Use of a drug to induce depression of consciousness by physician performing a procedure (5 years or older), initial 15 minutes (HCPCS:99152)
  • Heart rhythm review, and interpretation of continous external ekg over more than 48 hours up to 7 days (HCPCS:93244)
  • Ultrasound of heart, follow-up (HCPCS:93308)
  • Evaluation of single, dual, multiple lead or leadless pacemaker system (HCPCS:93288)
  • Established patient office or other outpatient visit, 40-54 minutes (HCPCS:99215)
  • Ultrasonic guidance for blood vessel access (HCPCS:76937)
  • Insertion of tube in left lower heart chamber and coronary artery for diagnosis with review by radiologist (HCPCS:93458)
  • Ultrasound study of arm and leg arteries (HCPCS:93922)
  • Initial hospital inpatient care per day, typically 70 minutes (HCPCS:99223)
  • Electrocardiogram (ecg) 2-day continuous with review by health care professional (HCPCS:93227)
  • Heart rhythm review, and interpretation of continous external ekg over more than 48 hours up to 7 days (HCPCS:93244)
  • Coronary angioplasty and stenting (HCPCS:NAN05)
  • Pacemaker insertion or repair (HCPCS:NAN10)

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
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 Identifier Other Provider Identifier Type Other Provider Identifier State Other 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: 11/21/2025

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