Individual provider Active NPI

Samantha Johanne Tatum, OT

  • Occupational Therapist
  • Nicholasville, KY
National Provider Identifier
1609414507
Registry record updated Dec 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
135045 Issued in KY
Practice address
610 E Brannon Road Suite 200
Nicholasville, KY 40356
NPI assigned
Dec 11, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 135045 KY Primary

Addresses

Primary practice location

610 E Brannon Road Suite 200
Nicholasville, KY 40356

Mailing address

5200 Commerce Crossing 3Rd Floor
Louisville, KY 40229
Phone (502) 489-6615

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address statum7579@bhkydirect.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200224002668 KY Practitioner - Occupational Therapist in Private Practice 2365879731 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Empowerme Rehabilitation Kentucky, LLCGroup PAC ID 1850729211, 108 clinicians

Practice addresses (Care Compare)

1165 Monarch St
Lexington, KY 40513-1979
Phone (844) 502-7996

Merit-based Incentive Payment System (MIPS)

Final score
94.29 of 100Reported as apm
Quality
87.32
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Health Medical Group Inc Occupational Therapist CurrentSince Jan 27, 2020 Accepting new patients
Baptist Health Medical Group Inc CurrentSince Jan 27, 2020 Accepting new patients
Empowerme Rehabilitation Kentucky, LLC Occupational Therapist CurrentSince Nov 6, 2025 Accepting new patients
Empowerme Rehabilitation Kentucky, LLC CurrentSince Nov 6, 2025 Accepting new patients

Locations

5200 Commerce Crossings Dr
Fl 3
Louisville, KY 40229
Phone (502) 253-4924

3900 Kresge Way
Ste 41
Louisville, KY 40207
Phone (502) 896-1313

610 E Brannon Rd
Ste 200
Nicholasville, KY 40356
Phone (859) 260-5555

610 E Brannon Rd
Nicholasville, KY 40356
Phone (859) 260-5540

1335 Strassner Dr
Saint Louis, MO 63144
Phone (314) 673-6723

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1576022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606953600000",
    "number": "1609414507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 COMMERCE CROSSING 3RD FLOOR",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "40229",
            "telephone_number": "502-489-6615",
            "fax_number": "502-489-5751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 E BRANNON ROAD SUITE 200",
            "city": "NICHOLASVILLE",
            "state": "KY",
            "postal_code": "40356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TATUM",
        "first_name": "SAMANTHA",
        "middle_name": "JOHANNE",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-11",
        "last_updated": "2020-12-03",
        "certification_date": "2020-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "KY",
            "license": "135045",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "statum7579@bhkydirect.com",
            "affiliation": "N",
            "address_1": "610 E Brannon Road Suite 200",
            "city": "Nicholasville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "40356",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Nicholasville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.