MR. DALTON ENRICO LATHAM (NP- NURSE PRACTITION) – Adult Health Nurse Practitioner, NPI 1194291179

MR. DALTON ENRICO LATHAM (NP- NURSE PRACTITION) is a healthcare provider. based in Berrien springs, Michigan. specializing in NURSE PRACTITIONER. They hold the professional credentials NP- NURSE PRACTITION. They hold a License No. 4704211443 (MI). The NPI Number for MR. DALTON ENRICO LATHAM (NP- NURSE PRACTITION) is 1194291179

Main info

Male
23 Years Of Experience
Accepts Medicare Assignment
Name
MR. DALTON ENRICO LATHAM (NP- NURSE PRACTITION)
NPI
1194291179
Phone
(269) 277-3260
Address
8521 KEPHART LANE
Enumeration Date
17 October 2018
Last Update Date
17 October 2018

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6058673313
Graduation Year
2003 (23 years ago)
PAC ID
5991037061
Group Practice PAC ID
4688571326
Professional Enrollment ID
I20191023002325
Address ID
SD575515835MA119XXAVEX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience33
Completeness75
Years active:7State licenses:1Digital endpointsOther names

8,105 NURSE PRACTITIONER in MI

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Provider Addresses for MR. DALTON ENRICO LATHAM (NP- NURSE PRACTITION)

  • 8521, Kephart Lane, Berrien Springs, Oronoko Charter Township, Berrien County, Michigan, 49103, United States

    BERRIEN SPRINGS, MI 49103

    Phone: (269) 277-3260

    Mailing address matches the actual address.

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: 2019-10-23

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
I20191023002325INurse PractitionerTXTBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99214Established patient office or other outpatient visit, 30-39 minutes227167$0
99213Established patient office or other outpatient visit, 20-29 minutes6760$0
View full utilization report →

Insurance plans in this area (ZIP 49103)

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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: 4688571326View full group profile

Reviews

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Frequently asked questions

What NPI should I save for MR. DALTON ENRICO LATHAM (NP- NURSE PRACTITION)?
Save NPI 1194291179 if you need a stable reference for MR. DALTON ENRICO LATHAM (NP- NURSE PRACTITION).
Is MR. DALTON ENRICO LATHAM (NP- NURSE PRACTITION)'s NPI currently valid?
The extract we use shows MR. DALTON ENRICO LATHAM (NP- NURSE PRACTITION) as active.
Does MR. DALTON ENRICO LATHAM (NP- NURSE PRACTITION) list a primary specialty?
If you are matching referrals, note Adult Health Nurse Practitioner for MR. DALTON ENRICO LATHAM (NP- NURSE PRACTITION). Clinical services aligned with this taxonomy classification.
What location shows for MR. DALTON ENRICO LATHAM (NP- NURSE PRACTITION)?
We surface Berrien Springs, Michigan for MR. DALTON ENRICO LATHAM (NP- NURSE PRACTITION) based on available NPPES addresses.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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