Craig Tatom, APN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

128312 Issued in MO

Practice address

Hwy 72 N Physicians Office Building II
Salem, MO 65560

Phone

(573) 729-6112

Fax

(573) 729-4035

NPI assigned

Sep 3, 2008

Last updated

Sep 3, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pcrmc Medical Group IncGroup PAC ID 1557454063, 113 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Phelps County Regional Medical Center Hospital, Rolla, MO, CCN 260017

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Pcrmc Medical Group, Inc

  dba Phelps Health Medical Group Rolla

  • Clinic/Center
  • Rolla, MO
  • NPI 1124237227
  Medicare reassignment Care Compare group NPD
• Phelps County Regional Medical Center

  dba Phelps Health

  • General Acute Care Hospital
  • Rolla, MO
  • NPI 1891766051
  Medicare reassignment NPD
• Phelps County Regional Medical Center

  dba Phelps Health Medical Group

  • Rural Health Clinic/Center
  • Rolla, MO
  • NPI 1366066037
  NPD
• Ozarks Medical Center

  dba Ozarks Healthcare

  • General Acute Care Hospital
  • West Plains, MO
  • NPI 1831115641
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Phelps County Regional Medical Center

  dba Phelps Health Medical Group

  • Rural Health Clinic/Center
  • Salem, MO
  • NPI 1194077701

  Hospital

  Care Compare affiliation
• Phelps County Regional Medical Center

  dba Phelps Health

  • Rehabilitation Hospital Unit
  • Rolla, MO
  • NPI 1346287455
  Care Compare affiliation
• Phelps County Regional Medical Center

  dba Phelps Health

  • General Acute Care Hospital
  • Rolla, MO
  • NPI 1891766051
  Care Compare affiliation

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

{
    "created_epoch": "1220400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1220400000000",
    "number": "1225286347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 69",
            "city": "SALEM",
            "state": "MO",
            "postal_code": "655600069",
            "telephone_number": "573-729-6112",
            "fax_number": "573-729-4035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HWY 72 N PHYSICIANS OFFICE BUILDING II",
            "city": "SALEM",
            "state": "MO",
            "postal_code": "65560",
            "telephone_number": "573-729-6112",
            "fax_number": "573-729-4035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TATOM",
        "first_name": "CRAIG",
        "name_prefix": "Mr.",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-03",
        "last_updated": "2008-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "128312",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "128312",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANCC CERTIFICATION",
            "identifier": "2008004369",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Yazhini Srivathsal, M.B.B.S.
• St Johns Clinic Inc (SJC-Salem)
• Dawn Stewart, LPN
• Amanda Stites, FNP
• Linda J Tarvin, APRN, BC, FNP
• Steven Taylor, LPC
• Tenda Group (Salem Care Center)
• Lauren Elizabeth Thompson, RN ADN
• Michelle Lee Tilberg, MA, PLPC 2021005293
• Jennifer L Tilley, LPC

• Family Nurse Practitioner in Salem, MO
• Providers in Salem, MO by specialty
• Family Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.