SHANE A LATHAM (AA) – Anesthesiologist Assistant, NPI 1144472838

SHANE A LATHAM (AA) is a healthcare provider. based in Atlanta, Georgia. specializing in ANESTHESIOLOGY ASSISTANT. They hold the professional credentials AA. They hold a License No. 005398 (GA). The NPI Number for SHANE A LATHAM (AA) is 1144472838

Main info

Male
18 Years Of Experience
Accepts Medicare Assignment
Name
SHANE A LATHAM (AA)
NPI
1144472838
Phone
(404) 851-7324
Address
5665 PEACHTREE DUNWOODY RD NE
Enumeration Date
14 October 2008
Last Update Date
10 December 2008

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4042571415
Graduation Year
2008 (18 years ago)
PAC ID
9830242106
Group Practice PAC ID
9830170059
Professional Enrollment ID
I20090804000330
Address ID
GA303425021AT5671XRDXX401
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience48
Completeness75
Years active:17State licenses:1Digital endpointsOther names

1,383 ANESTHESIOLOGY ASSISTANT in GA

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Provider Addresses for SHANE A LATHAM (AA)

  • Emory Saint Joseph's Hospital, 5665, Peachtree Dunwoody Road, Atlanta, Georgia, 30342, United States

    ATLANTA, GA 303421764

    Phone: (404) 851-7324

    Fax: (404) 843-2627

    Type: Location

  • Peachtree Dunwoody Road, Atlanta, Georgia, 30328, United States

    SUITE 530

    ATLANTA, GA 303425000

    Phone: (404) 257-1415

    Fax: (404) 851-1649

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2009-08-04

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20090804000330IAnesthesiology AssistantGATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 30342)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9830170059View full group profile
NameSpecialtyState
Anesthesiology AssistantGA
A N E S T H E S I O L O G YGA
Certified Registered Nurse Anesthetist (Crna)IL
Certified Registered Nurse Anesthetist (Crna)GA
-GA
Certified Registered Nurse Anesthetist (Crna)GA
Anesthesiology AssistantGA
Anesthesiology AssistantGA
Anesthesiology AssistantGA
Anesthesiology AssistantGA

Reviews

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Frequently asked questions

Can I cross-check SHANE A LATHAM (AA) using NPI 1144472838?
NPI 1144472838 belongs to SHANE A LATHAM (AA); compare other details if you need extra assurance.
Would SHANE A LATHAM (AA) appear as active to a payer?
You can treat SHANE A LATHAM (AA) as active for directory purposes; confirm clinical privileges separately.
What clinical focus is listed for SHANE A LATHAM (AA)?
At a glance, SHANE A LATHAM (AA) is tied to Anesthesiologist Assistant. Clinical services aligned with this taxonomy classification.
What locale is associated with SHANE A LATHAM (AA)?
Directory geography for SHANE A LATHAM (AA) centers on Atlanta, Georgia.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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