Jacquelina Otilia Tatum

Primary specialty

Mental Health Occupational TherapistTaxonomy code 225XM0800X

Practice address

6802 Paragon PL Ste 410
Richmond, VA 23230-1655

Phone

(919) 358-3730

Fax

(844) 892-9261

NPI assigned

Feb 9, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Jacquelina Otilia Churhill Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1549670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549670400000",
    "number": "1154886539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6802 PARAGON PL STE 410",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232301655",
            "telephone_number": "919-358-3730",
            "fax_number": "844-892-9261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6802 PARAGON PL STE 410",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232301655",
            "telephone_number": "919-358-3730",
            "fax_number": "844-892-9261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TATUM",
        "first_name": "JACQUELINA",
        "middle_name": "OTILIA",
        "name_prefix": "Miss",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-09",
        "last_updated": "2019-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XM0800X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACQUELINA",
            "last_name": "CHURHILL",
            "middle_name": "OTILIA",
            "prefix": "MRS.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Madison Taylor Tate, OTR
• Richard Tate, M.D.
• Troy L Tate, CCC-SLP
• Shanthi S. Tatineni, M.D.
• Ethel Tatum, RN
• James Luther Tatum, MD
• Susan Mottesheard Tatum, RD
• Tracey D Tatum, NP
• Kathleen Mary Tauer, NURSE PRACTITIONER
• Thomas F. Tauer, D.C.

• Mental Health Occupational Therapist in Richmond, VA
• Providers in Richmond, VA by specialty
• Mental Health Occupational Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2019; 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.