Tatum Brianne Colburn, DO

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

2024015531 Issued in MO

Practice address

1203 SW State Route 7
Blue Springs, MO 64014-3539

Phone

(816) 228-4770

NPI assigned

Apr 15, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

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.

• Centerpoint Medical Center of Independence, LLC

  • General Acute Care Hospital
  • Independence, MO
  • NPI 1942247044
  NPD (past)
• Children'S Mercy-Cockerell and McIntosh Pediatrics, Inc

  • Pediatrics Physician
  • Blue Springs, MO
  • NPI 1811528656
  NPD (past)

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

{
    "created_epoch": "1618444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718928000000",
    "number": "1144801804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1203 SW STATE ROUTE 7",
            "city": "BLUE SPRINGS",
            "state": "MO",
            "postal_code": "640143539",
            "telephone_number": "816-228-4770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1203 SW STATE ROUTE 7",
            "city": "BLUE SPRINGS",
            "state": "MO",
            "postal_code": "640143539",
            "telephone_number": "816-228-4770"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "530 NE Glen Oak Ave",
            "address_purpose": "LOCATION",
            "city": "Peoria",
            "state": "IL",
            "postal_code": "616370001",
            "country_code": "US",
            "telephone_number": "309-655-2274",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2401 Gillham Rd",
            "address_purpose": "LOCATION",
            "city": "Kansas City",
            "state": "MO",
            "postal_code": "641084619",
            "country_code": "US",
            "telephone_number": "816-701-5200",
            "fax_number": "816-302-9939",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COLBURN",
        "first_name": "TATUM",
        "middle_name": "BRIANNE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-15",
        "last_updated": "2024-06-21",
        "certification_date": "2024-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "2024015531",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IL",
            "license": "90200000X",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• CMC Walk in Med BS LLC
• Cockerell & McIntosh Pediatrics PC
• Cockerell & McIntosh Pediatrics, PC
• Charles Frederick Cockerell, MD
• Heather Lynn Colbert
• Sara Jane Cole, PSY.D.
• Glenn Mark Collet, PSYCHOLOGIST
• Collier Care Home, Inc
• Kristina Colling, DPT
• Myron Collins, DC

• Pediatrics Physician in Blue Springs, MO
• Providers in Blue Springs, MO by specialty
• Pediatrics Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.