Paul E Tatum III, MD

Primary specialty

Hospice and Palliative Medicine (Family Medicine) PhysicianTaxonomy code 207QH0002X

License

R9296 Issued in TX

Practice address

915 N Grand Blvd
Saint Louis, MO 63106-1621

Phone

(314) 652-4100

NPI assigned

Nov 9, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MO, TX2 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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Central Texas Palliative Care Associates

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Austin, TX
  • NPI 1487686226
  Medicare reassignment NPD
• Seton Family of Doctors

  • Neurological Surgery Physician
  • Austin, TX
  • NPI 1588997233

  Family Medicine

  Medicare reassignment NPD
• University of Texas at Austin Dell Medical School

  • General Practice Physician
  • Austin, TX
  • NPI 1073066239
  Medicare reassignment NPD
• Fairview Heights Medical Group SC

  • Multi-Specialty Clinic/Center
  • Saint Louis, MO
  • NPI 1679503668
  Medicare reassignment
• Seton Family of Doctors

  • Radiology Clinic/Center
  • Austin, TX
  • NPI 1275290694
  NPD
• University of Texas at Austin Dell Medical School

  • Ambulatory Surgical Clinic/Center
  • Austin, TX
  • NPI 1780218305
  NPD
• Hospice Austin

  • Community Based Hospice Care Agency
  • Austin, TX
  • NPI 1376503201

  Family Medicine

  NPD (past)
• TLC Healthcare Wound Specialists Inc

  • Internal Medicine Physician
  • Tucson, AZ
  • NPI 1699918235
  NPD (past)

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

{
    "created_epoch": "1131494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743552000000",
    "number": "1821079559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4107 SPICEWOOD SPRINGS RD STE 100",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787598645",
            "telephone_number": "512-397-3360",
            "fax_number": "512-343-7107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 N GRAND BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631061621",
            "telephone_number": "314-652-4100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4107 Spicewood Springs Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787598645",
            "country_code": "US",
            "telephone_number": "512-397-3360",
            "fax_number": "512-343-7107",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TATUM",
        "first_name": "PAUL",
        "middle_name": "E",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-09",
        "last_updated": "2025-04-02",
        "certification_date": "2025-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QH0002X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": "MO",
            "license": "2022022258",
            "primary": false
        },
        {
            "code": "207QH0002X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": "TX",
            "license": "R9296",
            "primary": true
        },
        {
            "code": "207QH0002X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": "IL",
            "license": "036160360",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807026",
            "state": "AZ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "BJC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2 Memorial Dr Ste 220",
            "city": "Alton",
            "state": "IL",
            "country_code": "US",
            "postal_code": "620026723",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Pearl Tate, LMSW
• Sandra L Tate, MD
• Sharon Ann Tate, LPN
• Kanayo Tatsumi, M.D
• Harold Anthony Tatum Jr., ACNP
• Tatum'S Tender Care
• Tatums Tender Care LLC
• Tatyana Petrosova, MD PC
• Tamara Taubodo
• Hannah Tauk, CRNA

• Hospice and Palliative Medicine (Family Medicine) Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Hospice and Palliative Medicine (Family Medicine) Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.