Active NPI
Haylee Tatum
- Speech-Language Pathologist
- Fort Worth, TX
National Provider Identifier
1194462358
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 115304
- Practice address
- 215 NE 14TH St
Fort Worth, TX 76164-8901 - Phone
- (817) 814-2000
- NPI assigned
- May 18, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 115304 | TX | Primary |
Addresses
Primary practice location
215 NE 14TH St
Fort Worth, TX 76164-8901
Mailing address
100 N University Dr
Fort Worth, TX 76107-1360
Other practice location 1
3816 Stadium Dr
Fort Worth, TX 76109-3712
Phone (817) 814-5300
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 659249401 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1652832000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1663804800000",
"number": "1194462358",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 N UNIVERSITY DR",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761071360"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "215 NE 14TH ST",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761648901",
"telephone_number": "817-814-2000"
}
],
"practiceLocations": [
{
"address_1": "3816 Stadium Dr",
"address_purpose": "LOCATION",
"city": "Fort Worth",
"state": "TX",
"postal_code": "761093712",
"country_code": "US",
"telephone_number": "817-814-5300",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "TATUM",
"first_name": "HAYLEE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-05-18",
"last_updated": "2022-09-22",
"certification_date": "2022-09-22",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "TX",
"license": "115304",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "659249401",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fort Worth, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 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.