NPIMap

Individual provider Active NPI

Tatum Bohls

  • Physician Assistant
  • Pflugerville, TX
National Provider Identifier
1487050175
Registry record updated Jul 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085005184 Issued in IL
Practice address
2600 E Pflugerville Pkwy
Pflugerville, TX 78660-5998
Phone
(512) 654-6100
NPI assigned
Nov 7, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085005184 IL Primary
Physician Assistant 363A00000X PA14672 TX

Addresses

Primary practice location

2600 E Pflugerville Pkwy
Pflugerville, TX 78660-5998

Mailing address

PO Box 844658
Dallas, TX 75284-4658

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tbohls914131@direct.sw.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211111000494 TX Practitioner - Physician Assistant 9830414077 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Scott and White ClinicGroup PAC ID 8123923604, 2,426 clinicians

Practice addresses (Care Compare)

10526 W Parmer LN BLDG
4 Baylor Scott and White Clinic Austi
Austin, TX 78717-4873
Phone (512) 310-4700

1605 S 31St St
Baylor Scott and White Center for Dia
Temple, TX 76508-0001
Phone (254) 215-0100

2401 S 31 St
Temple, TX 76508-0001
Phone (254) 724-2459

2401 S 31St St BLDG
35 Baylor Scott and White Roney Bone and
Temple, TX 76508-0001
Phone (254) 724-2663

300 University Blvd
Round Rock, TX 78665-1032
Phone (512) 509-0200

302 University Blvd
Round Rock, TX 78665-1032
Phone (512) 509-0200

425 University Blvd
Round Rock, TX 78665-1053
Phone (512) 509-0200

5330 Overpass Rd
Buda, TX 78610-2300

810 W U Ave
Temple, TX 76508-0001
Phone (254) 724-2585

Hospital & facility affiliations

  • Baylor Scott & White Medical Center - Round Rock Hospital, Round Rock, TX, CCN 670034
  • Baylor Scott & White Medical Center -Taylor Hospital, Taylor, TX, CCN 451374
  • Baylor Scott & White Medical Center Pflugerville Hospital, Pflugerville, TX, CCN 670128
  • Baylor Scott & White Medical Center - Marble Falls Hospital, Marble Falls, TX, CCN 670108
  • Baylor Scott & White Medical Center - Buda Hospital, Buda, TX, CCN 670131

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Nluc PLLC CurrentSince Oct 1, 2022 Accepting new patients
Baylor Scott & White Medical Centers - Capitol Area PastSince Jan 17, 2022 Accepting new patients

Locations

5211 FM 2920 Rd
Ste 101
Spring, TX 77388

16312 Southwest Fwy
Ste 18
Sugar Land, TX 77479

Organizations & group practices 5

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

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1415318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657152000000",
    "number": "1487050175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844658",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752844658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 E PFLUGERVILLE PKWY",
            "city": "PFLUGERVILLE",
            "state": "TX",
            "postal_code": "786605998",
            "telephone_number": "512-654-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOHLS",
        "first_name": "TATUM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-07",
        "last_updated": "2022-07-07",
        "certification_date": "2022-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085005184",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA14672",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tbohls914131@direct.sw.org",
            "affiliation": "N",
            "address_1": "2600 E Pflugerville Pkwy",
            "city": "Pflugerville",
            "state": "TX",
            "country_code": "US",
            "postal_code": "786605998",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pflugerville, TX

Sources for this page

Verify at the official NPI Registry.