Phillip Bradley Tatum, FNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

APN0000012073 Issued in TN

Practice address

115 E Brooklyn St
Linden, TN 37096-3515

Phone

(931) 589-2104

Fax

(931) 589-2513

NPI assigned

Jul 5, 2006

Last updated

Feb 26, 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

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: phillip.tatum.p1@direct.trchg.nextgenshare.com

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Perry County Medical Center Inc

  • Federally Qualified Health Center (FQHC)
  • Linden, TN
  • NPI 1154322303

  Corporate Officer, W-2 Managing Employee

  CMS ownership
• Perry County Medical Center, Inc.

  • Dental Clinic/Center
  • Linden, TN
  • NPI 1134937345

  Corporate Director, Corporate Officer, W-2 Managing Employee

  CMS ownership
• Perry County Medical Center, Inc.

  dba Three Rivers Community Health Group

  • Federally Qualified Health Center (FQHC)
  • Lyles, TN
  • NPI 1659567527

  Corporate Director, Corporate Officer, W-2 Managing Employee

  CMS ownership

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.

• Perry County Medical Center Inc

  • Federally Qualified Health Center (FQHC)
  • Linden, TN
  • NPI 1154322303
  Medicare reassignment NPD Authorized official
• Perry County Medical Center, Inc.

  • Dental Clinic/Center
  • Linden, TN
  • NPI 1134937345
  NPD Authorized official
• Perry County Medical Center, Inc.

  dba Three Rivers Community Health Group

  • Federally Qualified Health Center (FQHC)
  • Lyles, TN
  • NPI 1659567527
  NPD (past) Authorized official
• Perry County Medical Center, Inc.

  • General Practice Dentistry
  • Lyles, TN
  • NPI 1710535703
  Authorized official Same address or phone

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582675200000",
    "number": "1992736334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 916",
            "city": "LINDEN",
            "state": "TN",
            "postal_code": "370960916",
            "telephone_number": "931-589-2104",
            "fax_number": "931-589-2513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 E BROOKLYN ST",
            "city": "LINDEN",
            "state": "TN",
            "postal_code": "370963515",
            "telephone_number": "931-589-2104",
            "fax_number": "931-589-2513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TATUM",
        "first_name": "PHILLIP",
        "middle_name": "BRADLEY",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-05",
        "last_updated": "2020-02-26",
        "certification_date": "2020-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "APN0000012073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patricia W Smith
• Smiths Pharmacy
• State of Tennessee (Perry County Health Department)
• Stephen L. Averett
• Vivian Denise Stokes, FNP-C
• Christopher Brent Taylor, PHARMD
• Treatment Recovery Associates LLC
• Lawanda Gaye Trull, LPN
• Unity Hospice Care of Tennessee, LLC
• Vitality Direct Primary Care and Wellness

• Nurse Practitioner in Linden, TN
• Providers in Linden, TN by specialty
• Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.