| Mr Craig Tatom, APN | |
|
Hwy 72 N Physicians Office Building Ii, Salem, MO 65560 | |
| (573) 729-6112 | |
| (573) 729-4035 |
| Full Name | Mr Craig Tatom |
|---|---|
| Gender | Male |
| Speciality | Nurse Practitioner |
| Experience | 18 Years |
| Location | Hwy 72 N Physicians Office Building Ii, Salem, Missouri |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225286347 | NPI | - | NPPES |
| 128312 | Other | MO | STATE LICENSE |
| 2008004369 | Other | ANCC CERTIFICATION |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | 128312 (Missouri) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Phelps County Regional Medical Center | Rolla, MO | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Pcrmc Medical Group Inc | 1557454063 | 99 |
| Entity Name | Phelps County Regional Medical Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1891766051 PECOS PAC ID: 2860391158 Enrollment ID: O20040106000405 |
| Entity Name | Pcrmc Medical Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1124237227 PECOS PAC ID: 1557454063 Enrollment ID: O20070829000437 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Craig Tatom, APN Po Box 69, Salem, MO 65560-0069 Ph: (573) 729-6112 | Mr Craig Tatom, APN Hwy 72 N Physicians Office Building Ii, Salem, MO 65560 Ph: (573) 729-6112 |
Miriam Louise Brawley, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1415 W Scenic Rivers Blvd, Salem, MO 65560 Phone: 573-729-5533 Fax: 573-202-2466 | |
Karla A Callahan, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 501 S Grand St, Salem, MO 65560 Phone: 573-729-7071 Fax: 573-729-6949 | |
Brenda Gott, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 3103 Hh Highway, Salem, MO 65560 Phone: 573-729-2605 | |
Mrs. Kimberly Ann Kemnitzer, FNP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 216 W 3rd St, Salem, MO 65560 Phone: 573-453-5070 Fax: 573-340-6086 | |
Ms. Barbara C Fulton, A.P.R.N. Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1415 W Scenic Rivers Blvd, Salem, MO 65560 Phone: 573-729-5533 Fax: 573-202-2466 | |
Amanda Stites, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1010 E Scenic Rivers Blvd, Salem, MO 65560 Phone: 573-729-3106 |