Vaughn D Tatum, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036-056693 Issued in IL

Practice address

1834 Clairmont Rd # 100
Decatur, GA 30033-3405

Phone

(404) 634-4443

Fax

(708) 848-5270

NPI assigned

Aug 30, 2006

Last updated

Sep 18, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

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 1

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/18041/brand/1/csg/1/fhir/r4
• FHIR API: https://fhir4.healow.com/fhir/r4/BAGADD

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.

• Peachtree Immediate Care FP, LLC

  • Family Medicine Physician
  • Hiram, GA
  • NPI 1437194156
  Medicare reassignment NPD
• Peachtree Immediate Care UC, LLC

  • Urgent Care Clinic/Center
  • Decatur, GA
  • NPI 1235573841
  NPD
• Anwan Wellness Medical Center PC

  • Specialist
  • Hapeville, GA
  • NPI 1497842777
  NPD (past)

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600387200000",
    "number": "1841309994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4085 CREEKVIEW RIDGE DR",
            "city": "BUFORD",
            "state": "GA",
            "postal_code": "305188743",
            "telephone_number": "773-587-2616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1834 CLAIRMONT RD # 100",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300333405",
            "telephone_number": "404-634-4443",
            "fax_number": "708-848-5270"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "610 S Maple Ave",
            "address_2": "Suite 2100",
            "address_purpose": "LOCATION",
            "city": "Oak Park",
            "state": "IL",
            "postal_code": "603041091",
            "country_code": "US",
            "telephone_number": "708-848-7673",
            "fax_number": "708-848-5270",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TATUM",
        "first_name": "VAUGHN",
        "middle_name": "D",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2020-09-18",
        "certification_date": "2020-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036-056693",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036056693",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pamela G Tarver, N.P.
• Latoya K Tate, DPT
• Monica Tate, LCSW
• Patricia Tatro, LCSW
• Brandon Tatum
• Henry Douglas Taunton Jr., RPH
• Deborah Tawil, LMT,NMT
• Kamil Denise Taylor-Diggs, LMSW
• Alexis Charne Taylor, MS, BCBA
• Andaysha Renee Taylor, RBT

• Internal Medicine Physician in Decatur, GA
• Providers in Decatur, GA by specialty
• Internal Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2020; 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.