Individual provider Active NPI

Timothy Scott Tatum, M.D.

  • Diagnostic Radiology Physician
  • Blue Ash, OH
National Provider Identifier
1669732723
Registry record updated Jun 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
35133381 Issued in OH
Practice address
9825 Kenwood Rd Ste 105
Blue Ash, OH 45242-6252
Phone
(513) 872-4500
Fax
(513) 527-0416
NPI assigned
May 23, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Diagnostic Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0202X 35133381 OH Primary

Addresses

Primary practice location

9825 Kenwood Rd Ste 105
Blue Ash, OH 45242-6252

Mailing address

2624 Wendell Ave
Louisville, KY 40205-3138
Phone (502) 558-2689

Other practice location 1

2401 W University Ave
Muncie, IN 47303-3428
Phone (765) 741-1095

Other identifiers 2

IdentifierTypeStateIssuer
0280677MedicaidOH
G529780OtherOHMEDICARE OHIO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, OH, KY, VA4 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
I20170923000293 AL Practitioner - Diagnostic Radiology 9931349503 Reassigns benefits to 1 organization
I20180515001987 OH Practitioner - Diagnostic Radiology 9931349503 Reassigns benefits to 2 organizations
I20240502003088 KY Practitioner - Diagnostic Radiology 9931349503 Reassigns benefits to 1 organization
I20250717003164 VA Practitioner - Diagnostic Radiology 9931349503 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Professional Radiology IncGroup PAC ID 0941298764, 41 clinicians
Town Center Imaging 2 LLCGroup PAC ID 2860910171, 21 clinicians

Practice addresses (Care Compare)

2139 Auburn Ave
Cincinnati, OH 45219-2906
Phone (513) 872-4500

2144 N Fort Thomas Ave
Fort Thomas, KY 41075-1022
Phone (513) 872-4500

4677 Columbus St
Suite 101
Virginia Beach, VA 23462-6746
Phone (757) 943-3660

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
69.07 of 100Reported as group
Quality
57.65
Improvement activities
40
Cost
74.53

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35133381OHMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Radiology Inc. Multi-Specialty CurrentSince Jul 1, 2018 Accepting new patients
RCHP - Wilmington LLC CurrentSince Apr 12, 2022 Accepting new patients
Selma Radiology Associates P C Multi-Specialty CurrentSince Jul 1, 2017 Accepting new patients
Town Center Imaging 2 LLC Multi-Specialty CurrentSince Jul 1, 2025 Accepting new patients
RCHP-Wilmington, LLC Multi-Specialty CurrentSince Apr 12, 2022 Accepting new patients

Locations

105 US Highway 80 E
Demopolis, AL 36732
Phone (334) 287-2669

2055 Normandie Dr
Ste 200
Montgomery, AL 36111
Phone (205) 262-0655

2105 E South Blvd
Montgomery, AL 36116
Phone (334) 286-2842

2055 Normandie Dr
Ste 108
Montgomery, AL 36111
Phone (334) 288-4624

1015 Medical Center Pkwy
Selma, AL 36701
Phone (334) 418-4100

60 Mercy Ct
Irvine, KY 40336
Phone (606) 723-2115

9825 Kenwood Rd
Ste 105
Blue Ash, OH 45242
Phone (513) 527-0408

4600 McAuley Pl
Ste 600
Blue Ash, OH 45242
Phone (513) 752-8000

2139 Auburn Ave
Cincinnati, OH 45219
Phone (513) 585-0406

630 Eaton Ave
Hamilton, OH 45013
Phone (513) 867-2000

31 Farquhar Ave
Wilmington, OH 45177
Phone (937) 283-2273

4677 Columbus St
Ste 101
Virginia Beach, VA 23462
Phone (757) 943-3660

Organizations & group practices 5

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 6

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": "1337731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529107200000",
    "number": "1669732723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2624 WENDELL AVE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402053138",
            "telephone_number": "502-558-2689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9825 KENWOOD RD STE 105",
            "city": "BLUE ASH",
            "state": "OH",
            "postal_code": "452426252",
            "telephone_number": "513-872-4500",
            "fax_number": "513-527-0416"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2401 W University Ave",
            "address_purpose": "LOCATION",
            "city": "Muncie",
            "state": "IN",
            "postal_code": "473033428",
            "country_code": "US",
            "telephone_number": "765-741-1095",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TATUM",
        "first_name": "TIMOTHY",
        "middle_name": "SCOTT",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-05-23",
        "last_updated": "2018-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OH",
            "license": "35133381",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0280677",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE OHIO",
            "identifier": "G529780",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Blue Ash, OH

Sources for this page

Verify at the official NPI Registry.