Active NPI
Michael James Tatum, DO
- Optician
- Durham, NC
National Provider Identifier
1194998591
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- 1277
- Practice address
- 2351 Erwin Rd
Durham, NC 27705-4699 - Phone
- (919) 282-0053
- Fax
- (919) 282-0057
- NPI assigned
- Apr 7, 2008
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Optician | 156FX1800X | 1277 | NC | Primary |
Addresses
Primary practice location
2351 Erwin Rd
Durham, NC 27705-4699
Mailing address
7100 Six Forks Rd
Suite 301
Raleigh, NC 27615-6156
Phone (919) 847-0187
Other names 1
- Tatum Optical Shoppellc
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
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1277 | NC | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1207526400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1360627200000",
"number": "1194998591",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7100 SIX FORKS RD",
"address_2": "SUITE 301",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276156156",
"telephone_number": "919-847-0187",
"fax_number": "919-676-2231"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2351 ERWIN RD",
"city": "DURHAM",
"state": "NC",
"postal_code": "277054699",
"telephone_number": "919-282-0053",
"fax_number": "919-282-0057"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TATUM",
"first_name": "MICHAEL",
"middle_name": "JAMES",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-04-07",
"last_updated": "2013-02-12",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "NC",
"license": "1277",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "TATUM",
"last_name": "SHOPPELLC",
"middle_name": "OPTICAL",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Durham, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.