KIMBERLY ANNE TATUM (NPI# 1366704488) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366704488 |
| Entity Type | Individual |
| Full Name | KIMBERLY ANNE TATUM |
| Credential | N.P. |
| Practice Address |
1300 Baxter St Suite #170 Charlotte NC 28204-3053 |
| Practice Telephone | 7046127660 |
| Mailing Telephone | 7046127660 |
| Enumeration Date | 2012-06-14 |
| Last Update Date | 2017-03-10 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 5005656 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
5005656 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 7006143 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225258494 | Kimberly Gardner Tatum | Physical Therapist | 104 Silver Point Lane, Hattiesburg, MS 39402 | 2007-04-27 |
| 1518479542 | Kimberly Modena Tatum | Nurse Practitioner | 3201 University Dr E Ste 135, Bryan, TX 77802-3481 | 2017-10-31 |
| Street Address |
1300 BAXTER ST SUITE #170 |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28204-3053 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861450082 | Stephen Eric Cohen | Chiropractor | 1300 Baxter St, Suite 220, Charlotte, NC 28204-3053 | 2006-05-04 |
| 1184855900 | Khans Family, Inc. | Home Health | 1300 Baxter St, #240, Charlotte, NC 28204-3053 | 2009-07-28 |
| 1518001106 | Morris F Britt | Psychologist | 1300 Baxter St, Suite #195, Charlotte, NC 28204-3053 | 2007-02-16 |
| 1093868846 | Golden Age Rainbow Services Inc | Home Health | 1300 Baxter St, Suite 240, Charlotte, NC 28204-3053 | 2007-01-18 |
| 1225081565 | Laurie P.. Reed | Counselor | 1300 Baxter St, Suite 265, Charlotte, NC 28204-3053 | 2006-05-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285263582 | Precise Home Care Service LLC | In Home Supportive Care | 1935 Baxter Street, Unit 101, Charlotte, NC 28204 | 2020-04-07 |
| 1285276253 | Shannon Miller | Counselor | 1432 E Seventh Street, Charlotte, NC 28204 | 2019-10-11 |
| 1194282202 | Madison Joann Mcgarrigle | Behavior Technician | 1401 East 7th Street, Charlotte, NC 28204 | 2019-02-25 |
| 1255802674 | Stacey D. Alston, Dds, Pa | Dentist | 1020 E. 10th St., Suite 1, Charlotte, NC 28204 | 2018-12-11 |
| 1972082097 | Kim Webb Talbert | Nurse Practitioner | Novant Health Presbyterian Medical Center Charlotte, 200 Hawthorne Lane, Charlotte, NC 28204 | 2018-08-09 |
| 1164910535 | Jesse Elijah Roberts | Counselor | 1801 E 5th Street, #208, Charlotte, NC 28204 | 2018-05-01 |
| 1336696848 | Eight Healthcare | Exclusive Provider Organization | 2455 Weddington Ave, 2110, Charlotte, NC 28204 | 2016-09-01 |
| 1225480551 | Kathleen Quintana Bradley | Physician Assistant | 1523 Elizabeth Ave., Suite 200, Charlotte, NC 28204 | 2016-07-11 |
| 1184049777 | Della Franklin | Speech-Language Pathologist | 1021 Morehead Medical Dr Ste 3300, Charlotte, NC 28204 | 2014-02-19 |
| 1225459845 | Healing Arts Medical, Pa | Family Medicine | 335 N. Caswell Rd., Charlotte, NC 28204 | 2013-12-27 |
| Find all providers in zip 28204 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215544986 | Tonya Lynn Burris | Nurse Practitioner | 7810 Providence Rd Ste 102, Charlotte, NC 28226-2987 | 2020-09-28 |
| 1003428293 | Kashari Davis | Nurse Practitioner | 4252 Sutwick Dr, Charlotte, NC 28269-6001 | 2020-08-19 |
| 1457972796 | Lindsey O'brien | Nurse Practitioner | 3423 Hornets Nest Way, Charlotte, NC 28208-5224 | 2020-04-28 |
| 1285254904 | Barbara Ballard | Nurse Practitioner | 10731 Haddington Dr Nw, Charlotte, NC 28269-6954 | 2020-04-22 |
| 1710506787 | Lindsey Delcasino Plair | Nurse Practitioner | 1212 South Blvd, Charlotte, NC 28203-4215 | 2020-04-10 |
| 1457991275 | Advanced Physical Medicine | Nurse Practitioner | 8821 University East Dr # 120, Charlotte, NC 28213-4200 | 2020-01-09 |
| 1700447562 | Milford Darnell George Jr. | Nurse Practitioner | 8403 University Executive Park Drive, Suite 685, Charlotte, NC 28262-3330 | 2019-06-24 |
| 1194288241 | Tonya Denise Farmer | Nurse Practitioner | 620 Tom Hunter Road, Charlotte, NC 28213 | 2019-04-06 |
| 1649738204 | Brittany Schmalfeld | Nurse Practitioner | 8943 S Tryon St Unit K, Charlotte, NC 28273-3539 | 2019-03-03 |
| 1407313703 | Natalie Ann Bullock | Nurse Practitioner | 400 E Stonewall St Ste F, Charlotte, NC 28202-3601 | 2019-02-23 |
| Find all providers in CHARLOTTE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.