Leilani Tatum, NP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

1107543 Issued in TX

Practice address

1650 W Rosedale St
Fort Worth, TX 76104-7400

Phone

(469) 333-1543

NPI assigned

Jan 18, 2023

Sex

Female

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)

Not enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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.

• Shine Pediatrics and Wellness Center P.a.

  • Pediatrics Physician
  • Richardson, TX
  • NPI 1609110832
  NPD (past)

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

{
    "created_epoch": "1674000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674000000000",
    "number": "1497460992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 FORT EDWARD DR",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760024498",
            "telephone_number": "682-270-4448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 W ROSEDALE ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761047400",
            "telephone_number": "469-333-1543"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3600 Shire Blvd Ste 110",
            "address_purpose": "LOCATION",
            "city": "Richardson",
            "state": "TX",
            "postal_code": "750822236",
            "country_code": "US",
            "telephone_number": "469-333-1543",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TATUM",
        "first_name": "LEILANI",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-18",
        "last_updated": "2023-01-18",
        "certification_date": "2023-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "1107543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Tatone
• Belinda Tatum
• Carmen Marcella Tatum
• Haylee Tatum
• Larry D Tatum, MD
• Lyndsey Garrison Tatum, M.S., CCC-SLP
• Ross Tatum, M.D.
• Ryan Michael Taube, DO
• Kelly Tausend, APRN-FNP
• Melissa Layne Tavakoldavani, LPC

• Pediatric Nurse Practitioner in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Pediatric Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 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.