Active NPI
Tatum Mayfield Johnson
- Family Medicine Physician
- Hattiesburg, MS
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 904349
- Practice address
- 6766 U S Highway 98
Hattiesburg, MS 39402-8443 - Phone
- (601) 549-4877
- Fax
- (601) 901-6061
- NPI assigned
- Sep 6, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Family Medicine Physician | 207Q00000X | 904349 | MS | Primary |
Addresses
Primary practice location
6766 U S Highway 98
Hattiesburg, MS 39402-8443
Mailing address
314 Oral Church Rd
Sumrall, MS 39482-4021
Phone (601) 606-0558
Other practice location 1
4297 H/Wy 42
Bassfield, MS 39421
Phone (601) 550-3153
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MS
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
12261 Hwy 49
Suite 1
Gulfport, MS 39503-2976
Phone (228) 265-7185
14744 N Swan Rd
Gulfport, MS 39503-8582
Phone (601) 550-3153
2120 Enterprise Dr
Biloxi, MS 39531-4039
Phone (601) 550-3153
300 Cahal St
Hattiesburg, MS 39401-2922
Phone (601) 550-3153
6766 U S Hwy 98
Hattiesburg, MS 39402-8443
Phone (601) 550-3153
Hospital & facility affiliations
- Deaconess Homecare- Region I
- Singing River Health System
- Highland Community Hospital
- Memorial Hospital at Gulfport
- Jefferson Davis Community Hospital Cah
- Forrest General Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pioneer Health Care , LLC | Current | Accepting new patients | |
| Conx Care Corporation | Family Medicine | Past | Accepting new patients |
| Southern Medical Care | Family Medicine | Past | Accepting new patients |
Locations
4297 Hwy 42
Bassfield, MS 39421
Phone (601) 943-5060
15 Keystone Dr
Ste E
Hattiesburg, MS 39402
Phone (601) 606-6326
300 Cahal St
Hattiesburg, MS 39401
Phone (601) 582-9157
6766 U S Highway 98
Hattiesburg, MS 39402
Phone (601) 255-0010
Interoperability endpoints
- https://api.platform.athenahealth.com/8276/brand/1/csg/1/fhir/r4
- tatum.johnson.1@8276.direct.athenahealth.com
Organizations & group practices 5
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.
-
- General Practice Physician
- Bassfield, MS
- NPI 1336384742
-
- Family Medicine Physician
- Hattiesburg, MS
- NPI 1033537469
-
- Physical Therapist
- Gulfport, MS
- NPI 1023508348
-
- Family Medicine Physician
- Hattiesburg, MS
- NPI 1548183510
-
- Family Medicine Physician
- Hattiesburg, MS
- NPI 1740374560
Hospital & facility affiliations 66
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Picayune, MS
- NPI 1053350462
-
- General Acute Care Hospital
- Hattiesburg, MS
- NPI 1225041809
-
- Critical Access Hospital
- Prentiss, MS
- NPI 1295013316
-
- General Acute Care Hospital
- Gulfport, MS
- NPI 1073606901
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1599350400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1728000000000",
"number": "1124632187",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "314 ORAL CHURCH RD",
"city": "SUMRALL",
"state": "MS",
"postal_code": "394824021",
"telephone_number": "601-606-0558"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6766 U S HIGHWAY 98",
"city": "HATTIESBURG",
"state": "MS",
"postal_code": "394028443",
"telephone_number": "601-549-4877",
"fax_number": "601-901-6061"
}
],
"practiceLocations": [
{
"address_1": "4297 H/WY 42",
"address_purpose": "LOCATION",
"city": "Bassfield",
"state": "MS",
"postal_code": "39421",
"country_code": "US",
"telephone_number": "601-550-3153",
"fax_number": "601-901-6061",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JOHNSON",
"first_name": "TATUM",
"middle_name": "MAYFIELD",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-09-06",
"last_updated": "2024-10-04",
"certification_date": "2024-10-02",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MS",
"license": "904349",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hattiesburg, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2024; 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.