Joseph Amos Tatum Sr.

Primary specialty

DriverTaxonomy code 172A00000X

License

20218177072 Issued in CO

Practice address

102 W 26TH St
Rifle, CO 81650-3109

Phone

(505) 592-2851

NPI assigned

Jan 17, 2022

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

Other identifiers 1

Other names 1

• Mr. Joseph Amos Tatum Sr. Professional name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1642377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642377600000",
    "number": "1144971565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 W 26TH ST",
            "city": "RIFLE",
            "state": "CO",
            "postal_code": "816503109",
            "telephone_number": "505-592-2851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 W 26TH ST",
            "city": "RIFLE",
            "state": "CO",
            "postal_code": "816503109",
            "telephone_number": "505-592-2851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TATUM",
        "first_name": "JOSEPH",
        "middle_name": "AMOS",
        "name_prefix": "Mr.",
        "name_suffix": "Sr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-01-17",
        "last_updated": "2022-01-17",
        "certification_date": "2022-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172A00000X",
            "taxonomy_group": "",
            "desc": "Driver",
            "state": "CO",
            "license": "20218177072",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": ".",
            "identifier": "1993",
            "state": "CO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Roadrunnersllc12@gmail.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "102 W 26th St",
            "city": "Rifle",
            "state": "CO",
            "country_code": "US",
            "postal_code": "816503109",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JOSEPH",
            "last_name": "TATUM",
            "middle_name": "AMOS",
            "prefix": "MR.",
            "suffix": "SR.",
            "credential": "ROAD RUNNERS LLC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Driver in Rifle, CO
• Providers in Rifle, CO by specialty
• Driver in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2022; 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.