Individual provider Active NPI

Ashley M Jerath Tatum, M.D.

  • Allergy & Immunology Physician
  • Seattle, WA
National Provider Identifier
1174559686
Registry record updated Sep 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
MD00040523 Issued in WA
Practice address
9725 3Rd Ave NE Ste 500
Seattle, WA 98115-2024
Phone
(206) 527-1200
Fax
(206) 527-2514
NPI assigned
Jun 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X MD00040523 WA Primary

Addresses

Primary practice location

9725 3Rd Ave NE Ste 500
Seattle, WA 98115-2024

Mailing address

9725 3Rd Ave NE Ste 500
Seattle, WA 98115-2024
Phone (206) 527-1200

Other identifiers 3

IdentifierTypeStateIssuer
8290835MedicaidWA
030005331OtherWARAIL ROAD MEDICARE
7981JEOtherWAREGENCE

Other names 1

  • Ashley J Tatum Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100929000766 WA Practitioner - Allergy/Immunology 8022134873 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD00040523WAMDAllergy & Immunology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Asthma & Allergy Center Allergy & Immunology Current Accepting new patients
Children'S Hospital & Regional Medical Center 2 Past Accepting new patients
Northwest Asthma & Allergy Center Allergy & Immunology Past Accepting new patients
Northwest Asthma & Allergy Center Allergy & Immunology Past Accepting new patients

Locations

9725 3rd Ave NE
Ste 500
Seattle, WA 98115
Phone (206) 527-1200

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/26116/brand/1/csg/1/fhir/r4

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1151193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567468800000",
    "number": "1174559686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9725 3RD AVE NE STE 500",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981152024",
            "telephone_number": "206-527-1200",
            "fax_number": "206-527-2514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9725 3RD AVE NE STE 500",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981152024",
            "telephone_number": "206-527-1200",
            "fax_number": "206-527-2514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JERATH TATUM",
        "first_name": "ASHLEY",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-25",
        "last_updated": "2019-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "WA",
            "license": "MD00040523",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8290835",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "030005331",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE",
            "identifier": "7981JE",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ASHLEY",
            "last_name": "TATUM",
            "middle_name": "J",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.