Lindsey Rene Tatum, NP-C
Individual provider Active NPI Adult Health Nurse Practitioner · Waycross, GA
NPI 1659629772 · NPPES record last updated Jul 22, 2025
Key facts
- NPI
- 1659629772
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Adult Health Nurse Practitioner 363LA2200X
- License
- RN190678 (GA)
- Practice address
- 215 Pendleton St Ste 213
Waycross, GA 31501-2329 - Phone
- (912) 640-1008
- Fax
- (912) 640-1009
- NPI assigned
- Aug 21, 2012
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 6
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in GA, FL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170123001785 | GA | Practitioner - Nurse Practitioner | 2163704305 | Reassigns benefits to 3 organizations |
| I20250501002479 | FL | Practitioner - Nurse Practitioner | 2163704305 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN190678 | GA | MD | Adult Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Privia Medical Group of Georgia LLC | Current |
Accepting new patients | |
| Mending Minds Psychiatry, LLC | Psychiatric/Mental Health | Current |
Accepting new patients |
| Grow Healthcare Group PA | Psychiatric/Mental Health | Current |
Accepting new patients |
| Unison Behavioral Health | Current |
Accepting new patients | |
| Unison Behavioral Health | Current |
Accepting new patients | |
| Privia Medical Group of Georgia LLC | Current |
Accepting new patients |
Locations
66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711
715 Peachtree St NE
Ste 100
Atlanta, GA 30308
Phone (202) 972-4964
101 Yorktown Dr
Ste 100
Fayetteville, GA 30214
Phone (770) 460-4285
215 Pendleton St
Ste 213
Waycross, GA 31501
Phone (912) 640-1008
1007 Mary St
Waycross, GA 31503
Phone (912) 284-2547
Interoperability endpoints
- https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | RN190678 | GA | |
| Adult Health Nurse Practitioner | 363LA2200X | RN190678 | GA | Yes |
Addresses
Primary practice location
215 Pendleton St Ste 213
Waycross, GA 31501-2329
Mailing address
1501 Alice St
Waycross, GA 31501-4530
Phone (912) 285-0877
Other providers in Waycross, GA
- Taylor S Swinea
- T Carter LLC
- Betsy Erin Tanner
- Holly Tanner
- Laken Renee Tanner
- Ricky O Tatum
- Alice R Taylor
- Crystal L Taylor
- Leslie C. Taylor
- Shawana Mitchell Taylor
All providers in Waycross, GA · Adult Health Nurse Practitioner in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 22, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.