Active NPI
Elizabeth Tatum Athans, MD
- Pediatrics Physician
- Orlando, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- ME109486
- Practice address
- 9145 Narcoossee Rd
Suite 103
Orlando, FL 32827-5768 - Phone
- (407) 243-2040
- Fax
- (407) 243-2043
- NPI assigned
- Oct 2, 2008
- Last updated
- May 26, 2015
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | ME1097486 | FL | |
| General Practice Physician | 208D00000X | ME109486 | FL | |
| Pediatrics Physician | 208000000X | ME109486 | FL | Primary |
Addresses
Primary practice location
9145 Narcoossee Rd
Suite 103
Orlando, FL 32827-5768
Mailing address
P.O. Box 191
Rockland, DE 19732-0191
Phone (302) 651-6212
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 003539500 | Medicaid | FL |
Other names 1
- Elizabeth Latrelle Tatum
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME109486 | FL | MD | Pediatrics Physician |
| ME1097486 | FL | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Nemours Foundation | Current | Accepting new patients | |
| The Nemours Foundation | Current | Accepting new patients | |
| The Nemours Foundation | Current | Accepting new patients |
Locations
1371 Citrus Tower Blvd
Clermont, FL 34711
Phone (352) 394-2205
10140 Centurion Pkwy N
Jacksonville, FL 32256
Phone (904) 697-4100
807 Childrens Way
Jacksonville, FL 32207
Phone (904) 390-3600
9145 Narcoossee Rd
Ste 103
Orlando, FL 32827
Phone (407) 243-2040
Interoperability endpoints
- eathans40270@direct.nemours.org
Organizations & group practices 3
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.
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- Multi-Specialty Clinic/Center
- Jacksonville, FL
- NPI 1265585806
-
- Children's Hospital
- Wilmington, DE
- NPI 1467505073
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1222905600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1432598400000",
"number": "1902057417",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P.O. BOX 191",
"city": "ROCKLAND",
"state": "DE",
"postal_code": "197320191",
"telephone_number": "302-651-6212",
"fax_number": "302-651-4945"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9145 NARCOOSSEE RD",
"address_2": "SUITE 103",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328275768",
"telephone_number": "407-243-2040",
"fax_number": "407-243-2043"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ATHANS",
"first_name": "ELIZABETH",
"middle_name": "TATUM",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-10-02",
"last_updated": "2015-05-26",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "FL",
"license": "ME1097486",
"primary": false
},
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "FL",
"license": "ME109486",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "FL",
"license": "ME109486",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "003539500",
"state": "FL"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "ELIZABETH",
"last_name": "TATUM",
"middle_name": "LATRELLE",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in Orlando, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2015; 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.