Individual provider Active NPI

Lindsey Rene Tatum, NP-C

  • Adult Health Nurse Practitioner
  • Waycross, GA
National Provider Identifier
1659629772
Registry record updated Jul 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
RN190678 Issued in 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
Last updated
Jul 22, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RN190678 GA
Adult Health Nurse Practitioner 363LA2200X RN190678 GA Primary

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
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

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

State licenses

LicenseStateTypeSpecialty
RN190678GAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group of Georgia LLC CurrentSince Sep 29, 2018 Accepting new patients
Mending Minds Psychiatry, LLC Psychiatric/Mental Health CurrentSince Aug 17, 2025 Accepting new patients
Grow Healthcare Group PA Psychiatric/Mental Health CurrentSince Mar 28, 2025 Accepting new patients
Privia Medical Group of Georgia LLC CurrentSince Sep 29, 2018 Accepting new patients
Unison Behavioral Health CurrentSince Aug 1, 2019 Accepting new patients
Unison Behavioral Health CurrentSince Aug 1, 2019 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

1007 Mary St
Waycross, GA 31503
Phone (912) 284-2547

215 Pendleton St
Ste 213
Waycross, GA 31501
Phone (912) 640-1008

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4

Organizations & group practices 6

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

NPI Registry JSON

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

{
    "created_epoch": "1345507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753142400000",
    "number": "1659629772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 ALICE ST",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315014530",
            "telephone_number": "912-285-0877",
            "fax_number": "912-287-0387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 PENDLETON ST STE 213",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315012329",
            "telephone_number": "912-640-1008",
            "fax_number": "912-640-1009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TATUM",
        "first_name": "LINDSEY",
        "middle_name": "RENE",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-21",
        "last_updated": "2025-07-22",
        "certification_date": "2025-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "RN190678",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "GA",
            "license": "RN190678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waycross, GA

Sources for this page

Verify at the official NPI Registry.