Active NPI
Jesi Marie Tatum
- Administrator Registered Nurse
- Pawhuska, OK
National Provider Identifier
1730416652
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Administrator Registered Nurse
- License
- 0105139
- Practice address
- 1101 E 15TH St
Pawhuska, OK 74056-1901 - Phone
- (918) 287-3232
- NPI assigned
- Nov 13, 2009
- Last updated
- Oct 16, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Administrator Registered Nurse | 163WA2000X | 0105139 | OK | Primary |
Addresses
Primary practice location
1101 E 15TH St
Pawhuska, OK 74056-1901
Mailing address
PO Box 1382
Pawhuska, OK 74056-1382
Phone (918) 440-9240
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0105139 | OK | MD | Administrator Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1258070400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1413417600000",
"number": "1730416652",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1382",
"city": "PAWHUSKA",
"state": "OK",
"postal_code": "740561382",
"telephone_number": "918-440-9240"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1101 E 15TH ST",
"city": "PAWHUSKA",
"state": "OK",
"postal_code": "740561901",
"telephone_number": "918-287-3232"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TATUM",
"first_name": "JESI",
"middle_name": "MARIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-11-13",
"last_updated": "2014-10-16",
"status": "A"
},
"taxonomies": [
{
"code": "163WA2000X",
"taxonomy_group": "",
"desc": "Registered Nurse, Administrator",
"state": "OK",
"license": "0105139",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pawhuska, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.