Derek John Tatum

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0110006682 Issued in VA

Practice address

11020 Hull Street Rd
Midlothian, VA 23112-3200

Phone

(804) 744-6310

NPI assigned

Dec 16, 2018

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in VA, DC2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Physician Assistant

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Orthovirginia IncGroup PAC ID 0547157224, 570 clinicians

Derm Associates LLCGroup PAC ID 4688653306, 44 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: vaexchange@patientfirstclinics.com
• Direct secure messaging: dtatum33387@direct.orthovirginia.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Orthovirginia Inc

  • Multi-Specialty Clinic/Center
  • Mechanicsville, VA
  • NPI 1487671822
  Medicare reassignment Care Compare group
• Alexandria Springfield Emergency Physicians PC

  • Emergency Medicine Physician
  • Franklin, VA
  • NPI 1740529700
  Medicare reassignment NPD
• Patient First Richmond Medical Group PLLC

  • Family Medicine Physician
  • Glen Allen, VA
  • NPI 1689603748

  DC

  Medicare reassignment NPD
• Anne Arundel Dermatology LLC

  • Dermatology Physician
  • Annapolis, MD
  • NPI 1063481703

  DC, VA

  Medicare reassignment NPD
• Emergency Medicine Associates, P.a.,P.C.

  • Internal Medicine Physician
  • Dulles, VA
  • NPI 1376917070
  Medicare reassignment
• Emergency Coverage Services, PC

  • Nurse Practitioner
  • Lawrenceburg, TN
  • NPI 1053351593

  VA

  Medicare reassignment
• Emergency Coverage, LLC

  • Family Medicine Physician
  • Newport, TN
  • NPI 1427005008

  VA

  Medicare reassignment
• Derm Associates LLC

  • Dermatology Physician
  • Silver Spring, MD
  • NPI 1649271354
  Care Compare group
• Alexandria Springfield Emergency Physicians PC

  • Emergency Medicine Physician
  • Alexandria, VA
  • NPI 1720839764
  NPD
• Emergency Medicine Associates P.a., P.C.

  • Emergency Medicine Physician
  • Falls Church, VA
  • NPI 1134117393
  NPD
• Emergency Medicine Associates P.a., P.C.

  • Internal Medicine Physician
  • Culpeper, VA
  • NPI 1881559102
  NPD
• Orthovirginia, Inc

  • Physical Medicine & Rehabilitation Physician
  • Arlington, VA
  • NPI 1376411413
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1544918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648598400000",
    "number": "1013488246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 COX RD",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230609263",
            "telephone_number": "804-968-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11020 HULL STREET RD",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231123200",
            "telephone_number": "804-744-6310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TATUM",
        "first_name": "DEREK",
        "middle_name": "JOHN",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-12-16",
        "last_updated": "2022-03-30",
        "certification_date": "2022-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110006682",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "VAExchange@patientfirstclinics.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "11020 Hull Street Rd",
            "city": "Midlothian",
            "state": "VA",
            "country_code": "US",
            "postal_code": "231123200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Tawanda L Tarpley-Tedder, CEO
• Laprecious Tierra Tarpley, LCSW
• Robert W Tart, D.M.D
• Amber Nicole Tate, MS, PMHNP-BC
• Denise Evadne Tatum, LCSW
• Payaam Patrick Tavakoli, DPM
• Brittany Taylor Shredl
• Amy Taylor
• Ayantie Taylor, RRT
• Christine M Taylor, LMT

• Physician Assistant in Midlothian, VA
• Providers in Midlothian, VA by specialty
• Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.