John Benjamin David Tatum, DD PHD

Primary specialty

Pastoral CounselorTaxonomy code 101YP1600X

Practice address

99 Dawson Avenue
Back Door @ Top of W/C Ramp
Mansfield, OH 44906-3201

Phone

(419) 524-8337

NPI assigned

Mar 10, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 9

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

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

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    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552176000000",
    "number": "1174081095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 DAWSON AVENUE",
            "address_2": "BACK DOOR @ TOP OF W/C RAMP",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449063201",
            "telephone_number": "419-524-8337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 DAWSON AVENUE",
            "address_2": "BACK DOOR @ TOP OF W/C RAMP",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449063201",
            "telephone_number": "419-524-8337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TATUM",
        "first_name": "JOHN",
        "middle_name": "BENJAMIN DAVID",
        "credential": "DD PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-03-10",
        "last_updated": "2019-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "146D00000X",
            "taxonomy_group": "",
            "desc": "Personal Emergency Response Attendant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "174200000X",
            "taxonomy_group": "",
            "desc": "Meals",
            "state": null,
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        },
        {
            "code": "177F00000X",
            "taxonomy_group": "",
            "desc": "Lodging",
            "state": null,
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        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
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        },
        {
            "code": "253Z00000X",
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        {
            "code": "347C00000X",
            "taxonomy_group": "",
            "desc": "Private Vehicle",
            "state": null,
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        },
        {
            "code": "374K00000X",
            "taxonomy_group": "",
            "desc": "Religious Nonmedical Practitioner",
            "state": null,
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        },
        {
            "code": "376J00000X",
            "taxonomy_group": "",
            "desc": "Homemaker",
            "state": null,
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            "primary": false
        },
        {
            "code": "101YP1600X",
            "taxonomy_group": "",
            "desc": "Counselor, Pastoral",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pastoral Counselor in Mansfield, OH
• Providers in Mansfield, OH by specialty
• Pastoral Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 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.