Individual provider Active NPI

Enid Tatum, FNP-BC

  • Family Nurse Practitioner
  • Newport News, VA
National Provider Identifier
1558720672
Registry record updated Feb 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024173225 Issued in VA
Practice address
500 J Clyde Morris Blvd
Newport News, VA 23601-1929
Phone
(757) 594-2050
NPI assigned
Feb 17, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0024173225 VA Primary

Addresses

Primary practice location

500 J Clyde Morris Blvd
Newport News, VA 23601-1929

Mailing address

500 J Clyde Morris Blvd
Newport News, VA 23601-1929
Phone (757) 594-2050

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160511001020 VA Practitioner - Nurse Practitioner 5890084099 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Riverside Physician Services IncGroup PAC ID 5092608448, 793 clinicians

Practice addresses (Care Compare)

1500 Commonwealth Ave
Williamsburg, VA 23185-5229
Phone (757) 585-2250

Hospital & facility affiliations

  • Riverside Regional Medical Center Hospital, Newport News, VA, CCN 490052

Merit-based Incentive Payment System (MIPS)

Final score
94.91 of 100Reported as apm
Quality
92.86
Promoting interoperability
94.93
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0024173225VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside Physician Services Inc CurrentSince Jan 1, 2016 Accepting new patients
Riverside Physician Services Inc CurrentSince Jan 1, 2016 Accepting new patients
Riverside Physician Services Inc Current Accepting new patients

Locations

500 J Clyde Morris Blvd
North North, VA 23601
Phone (757) 594-2000

1500 Commonwealth Ave
Williamsburg, VA 23185
Phone (757) 585-2200

Interoperability endpoints

  • Direct secure messaging: etatum11788@direct.rivhs.com

Organizations & group practices 3

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 1

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": "1455667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455667200000",
    "number": "1558720672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 J CLYDE MORRIS BLVD",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236011929",
            "telephone_number": "757-594-2050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 J CLYDE MORRIS BLVD",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236011929",
            "telephone_number": "757-594-2050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TATUM",
        "first_name": "ENID",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-17",
        "last_updated": "2016-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024173225",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport News, VA

Sources for this page

Verify at the official NPI Registry.