Kevan Scott Tatum

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

CDCA.183657 Issued in OH

Practice address

3035 W Broad St
Columbus, OH 43204-2653

Phone

(614) 272-7005

NPI assigned

Sep 28, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1695859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695859200000",
    "number": "1306625314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1155 GEORGES PL APT B",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432041079",
            "telephone_number": "614-704-2437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3035 W BROAD ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432042653",
            "telephone_number": "614-272-7005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TATUM",
        "first_name": "KEVAN",
        "middle_name": "SCOTT",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-09-28",
        "last_updated": "2023-09-28",
        "certification_date": "2023-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "CDCA.183657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chris Tatum Sr.
• Courtney Renee Tatum
• Erin Lindsay Tatum, RN
• Gloria Jean Tatum, CDCA, SWA
• Josiephine Tatum
• Najee Sha-Ta Tatum, CDCA
• Harry Taubman, RPH
• Taurix Mobility Services
• Robert Tavani
• Sabrina Kristine Tavella-Burka, DO

• Addiction (Substance Use Disorder) Counselor in Columbus, OH
• Providers in Columbus, OH by specialty
• Addiction (Substance Use Disorder) Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2023; 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.