NPIMap

Individual provider Active NPI

Robert R Tatum, PA-C

  • Physician Assistant
  • Louisville, KY
National Provider Identifier
1801841325
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA500 Issued in KY
Practice address
530 South Jackson Street
DHC
Louisville, KY 40202
Phone
(502) 562-6500
Fax
(502) 562-6196
NPI assigned
May 23, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA500 KY Primary

Addresses

Primary practice location

530 South Jackson Street
DHC
Louisville, KY 40202

Mailing address

501 E Broadway
#220
Louisville, KY 40202-1785
Phone (502) 589-4856

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060614000003 KY Practitioner - Physician Assistant 3678598588 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

401 E Chestnut St
Louisville, KY 40202-5700

571 S Floyd St
Louisville, KY 40202-3818
Phone (502) 629-2398

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.96 of 100Reported as group
Quality
56.12
Promoting interoperability
100
Improvement activities
40
Cost
73.73

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA500KYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University of Louisville Physicians, Inc. CurrentSince Apr 28, 2014 Accepting new patients
University of Louisville Physicians, Inc. CurrentSince Apr 28, 2014 Accepting new patients
University of Louisville Physicians, Inc. Past Accepting new patients
University of Louisville Physicians Inc. Past Accepting new patients
University Medical Services Foundation Inc Past Accepting new patients

Locations

7752 Solution Ctr
Chicago, IL 60677

201 Abraham Flexner Way
Ste 1001
Louisville, KY 40202
Phone (502) 589-6788

401 E Chestnut St
Unit 310
Louisville, KY 40202
Phone (502) 584-8563

530 S Jackson St
Louisville, KY 40202
Phone (502) 562-3000

571 S Floyd St
Louisville, KY 40202
Phone (502) 561-2700

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.

Hospital & facility affiliations 23

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1801841325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 E BROADWAY",
            "address_2": "#220",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021785",
            "telephone_number": "502-589-4856",
            "fax_number": "502-589-5093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 SOUTH JACKSON STREET",
            "address_2": "DHC",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "40202",
            "telephone_number": "502-562-6500",
            "fax_number": "502-562-6196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TATUM",
        "first_name": "ROBERT",
        "middle_name": "R",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.