Individual provider Active NPI

Ronic Shenay Tatum, NP

  • Family Nurse Practitioner
  • Cerritos, CA
National Provider Identifier
1093065765
Registry record updated Sep 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
22347 Issued in CA
Practice address
12898 Towne Center Dr
Cerritos, CA 90703-8546
Phone
(310) 429-1387
NPI assigned
Sep 11, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 19, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 22347 CA Primary

Addresses

Primary practice location

12898 Towne Center Dr
Cerritos, CA 90703-8546

Mailing address

12898 Towne Center Dr
Cerritos, CA 90703-8546
Phone (310) 429-1387

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20130401000298 CA Practitioner - Nurse Practitioner 9739324450 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Albion Medical Partners of California West P CGroup PAC ID 8921419813, 28 clinicians

Practice addresses (Care Compare)

12900 Park Plaza Dr
Suite 700
Cerritos, CA 90703-9329
Phone (562) 622-2800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Albion Medical Partners of California West P C CurrentSince Feb 1, 2021 Accepting new patients
Caremore Health Medical Partners, PC Past Accepting new patients
Carelon Medical Partners, PC Past Accepting new patients

Locations

12900 Park Plaza Dr
Ste 700
Cerritos, CA 90703
Phone (562) 622-2800

12900 Park Plaza Dr
Ste 150
Cerritos, CA 90703
Phone (562) 622-2800

Interoperability endpoints

  • Direct secure messaging: ronic.tatum.1@32527.direct.athenahealth.com
  • Direct secure messaging: ronic.tatum.p1@direct.caremorewest.nextgenshare.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1347321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411084800000",
    "number": "1093065765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12898 TOWNE CENTER DR",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907038546",
            "telephone_number": "310-429-1387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12898 TOWNE CENTER DR",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907038546",
            "telephone_number": "310-429-1387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TATUM",
        "first_name": "RONIC",
        "middle_name": "SHENAY",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-11",
        "last_updated": "2014-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "22347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cerritos, CA

Sources for this page

Verify at the official NPI Registry.