Individual provider Active NPI

Matthew Wayne Tatom, D.O.

  • Family Medicine Physician
  • Lynchburg, VA
National Provider Identifier
1992811020
Registry record updated Aug 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0102037129 Issued in VA
Practice address
2832 Candlers Mountain Rd
Lynchburg, VA 24502-2287
Phone
(434) 239-3949
Fax
(434) 239-6982
NPI assigned
Aug 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0102037129 VA Primary
Surgery Physician 208600000X 0102037129 VA

Addresses

Primary practice location

2832 Candlers Mountain Rd
Lynchburg, VA 24502-2287

Mailing address

2832 Candlers Mountain Rd
Lynchburg, VA 24502-2287
Phone (434) 239-3949

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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

Enrollment IDStateProvider typePAC IDDetails
I20101025000499 VA Practitioner - Family Practice 2163404682 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Privia Medical Group, LLCGroup PAC ID 4385682061, 1,522 clinicians

Practice addresses (Care Compare)

2832 Candlers Mountain Rd
Lynchburg, VA 24502-2287
Phone (434) 239-3949

8644 Sudley Rd
Suite 220
Manassas, VA 20110-4425
Phone (571) 366-8845

950 N Glebe Rd
Suite 700
Arlington, VA 22203-4173

Hospital & facility affiliations

  • Centra Home Health Home health agency, Lynchburg, VA, CCN 497278
  • Centra Health - Lynchburg Gen Hospital Hospital, Lynchburg, VA, CCN 490021

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
0102037129VAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group, LLC CurrentSince Sep 29, 2016 Accepting new patients
Privia Medical Group, LLC Family Medicine CurrentSince Sep 29, 2016 Accepting new patients
A G Jefferson Inc PastSince Aug 1, 1993 Accepting new patients

Locations

2832 Candlers Mountain Rd
Lynchburg, VA 24502
Phone (434) 239-3949

8644 Sudley Rd
#220
Manassas, VA 20110

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 and National Provider Directory roles.

Hospital & facility affiliations 8

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

NPI Registry JSON

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409184000000",
    "number": "1992811020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2832 CANDLERS MOUNTAIN RD",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245022287",
            "telephone_number": "434-239-3949",
            "fax_number": "434-239-6982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2832 CANDLERS MOUNTAIN RD",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245022287",
            "telephone_number": "434-239-3949",
            "fax_number": "434-239-6982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TATOM",
        "first_name": "MATTHEW",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-22",
        "last_updated": "2014-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0102037129",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "VA",
            "license": "0102037129",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynchburg, VA

Sources for this page

Verify at the official NPI Registry.