Clifton Tatum, MD

Primary specialty

Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X

License

26863 Issued in KY

Practice address

200 E Gray St
Louisville, KY 40202-2012

Phone

(502) 629-7601

NPI assigned

Jul 11, 2005

Last updated

Jan 25, 2013By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Open MRI, LLC

  dba HIgh Field and Open MRI

  • Body Imaging Physician
  • Louisville, KY
  • NPI 1770550550
  NPD (past)
• Kentuckiana Diagnostics

  • Diagnostic Radiology Physician
  • Jeffersonville, IN
  • NPI 1225030901
  NPD (past)

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

{
    "created_epoch": "1121040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359072000000",
    "number": "1366440687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "234 E GRAY ST",
            "address_2": "SUITE 850",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021900",
            "telephone_number": "502-585-1735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 E GRAY ST",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402022012",
            "telephone_number": "502-629-7601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TATUM",
        "first_name": "CLIFTON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-11",
        "last_updated": "2013-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "KY",
            "license": "26863",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan S.B. Tate, M.D.
• Taylor Lauren Tate, COTA/L
• Vera Tate, M.D.
• Omar Tattan
• Brittney Tatum
• Robert R Tatum, PA-C
• Tatyanas Case Management, LLC
• Tatyanas Case Management, LLC
• Tatyanas Case Management, LLC
• Tatyanas Case Management, LLC

• Vascular & Interventional Radiology Physician in Louisville, KY
• Providers in Louisville, KY by specialty
• Vascular & Interventional Radiology Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 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.

Verify at the official NPI Registry.