Organization Active NPI

Tatum Internal Medicine & Associates PLLC

  • Legal Medicine
  • Phoenix, AZ
National Provider Identifier
1306974217
Registry record updated Sep 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Legal MedicineTaxonomy code 173000000X
License
20889 Issued in AZ
Legal business name
TATUM INTERNAL MEDICINE & ASSOCIATES PLLC
Practice address
4729 E Union Hills Dr
Ste #111
Phoenix, AZ 85050-3390
Phone
(602) 482-5444
Fax
(602) 482-5666
NPI assigned
Mar 1, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2010

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

Authorized official

Name
Mrs. Heidi B Cariati
Title
Office Administrator
Phone
(602) 482-5444

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Legal MedicineGroup: 193400000X SINGLE SPECIALTY GROUP 173000000X 20889 AZ Primary

Addresses

Primary practice location

4729 E Union Hills Dr
Ste #111
Phoenix, AZ 85050-3390

Mailing address

4729 E Union Hills Dr
# 111
Phoenix, AZ 85050-3390
Phone (602) 482-5444

Other identifiers 1

IdentifierTypeStateIssuer
1306974217OtherAZGROUP NPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040706001137 AZ Part B Supplier - Clinic/Group Practice 3870570989 Receives reassigned benefits from 1 practitioner
Practice locations: Scottsdale, AZ

National Provider Directory

National Provider Directory

Locations

14640 N Tatum Blvd
Ste 3
Phoenix, AZ 85032
Phone (602) 482-5444

4729 E Union Hills Dr
Ste 111
Phoenix, AZ 85050
Phone (602) 482-5444

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1284336000000",
    "number": "1306974217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4729 E UNION HILLS DR",
            "address_2": "# 111",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850503390",
            "telephone_number": "602-482-5444",
            "fax_number": "602-482-5666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4729 E UNION HILLS DR",
            "address_2": "STE #111",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850503390",
            "telephone_number": "602-482-5444",
            "fax_number": "602-482-5666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TATUM INTERNAL MEDICINE & ASSOCIATES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-01",
        "last_updated": "2010-09-13",
        "status": "A",
        "authorized_official_last_name": "CARIATI",
        "authorized_official_first_name": "HEIDI",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OFFICE ADMINISTRATOR",
        "authorized_official_telephone_number": "602-482-5444",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "173000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Legal Medicine",
            "state": "AZ",
            "license": "20889",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1306974217",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.