NPI age
20 years
Enumerated 2005-07-26
● Active
Type 1 · Individual
MR. Ricky Dwayne Latham, MD
Latham is 1 of 11 internal medicine providers in Idaho Falls and 1 of 100 in Idaho.
Primary specialty
Internal Medicine
Plus 1 subspecialty
Licensed in
OR, ID
2 states
Status
Active
No deactivations on record
Last NPPES update
2019-02-13
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 100 active internal medicine providers in Idaho.
NPI age
20 years
≈ at median (19 yr)
State licenses
2 states
Top 69% — 31% of peers are multi-state
Subspecialties
0
47% of peers hold subspecialties
NPI lifetime · 2005 → 2026
2005-07Enumerated in NPPES
2005
2026
Where they practice
Practice location
2001 Valenica Drive, Suite 201
Idaho Falls, ID 83404
Mailing address
1775 Thompson Rd
Coos Bay, OR 974202125
Specialties
-
Internal Medicine PrimaryAn 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.
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 | 111489100 | MEDICAID WYOMING, MWY |
| 01 | 000010005099 | BLUE SHIELD OF ID, BS |
| 01 | 060053550 | RAILROAD MEDICARE, RRM |
| 01 | DZ692 | BLUE CROSS OF ID SE, BC2 |
| 01 (ID) | M6887 | ID |
| 01 | 000010005099 | BLUE SHIELD OF ID S, BS2 |
| 01 | 000353200 | EDS- MEDICAID, EDS |
| 01 | 111489100 | WY/EDS CONSULTEC, INC WYM |
| 01 | 8318842 | MEDICAID OF WA, MD-W |
| 01 | DZ692 | BLUE CROSS OF IDAHO, BC |
| 05 (ID) | 000353200 | |
| 05 (OR) | 500680039 | |
| 01 | 0031512 | MONTANA MEDICAID, MEM |
| 01 | 1134041 | MEDICARE-CIGNA, MC |
Multi-state credentialing: Licensed in 2 states. Useful context for credentialers building cross-state provider networks.
Practice context
Solo or small practice. No other active providers share this practice address in NPPES.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Check the state license is currently active.State licensing boards publish current status; NPPES does not.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.