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KIM TATUM APRN
NPI 1073005419
Nurse Practitioner - Family in Las Vegas, NV

Active since June 01, 2018PECOS EnrolledAccepts Medicare Assignment
9454 DEL WEBB BLVD, LAS VEGAS, NV 89134(702) 940-1580(702) 940-1581 Get Directions Write a Review

NPPES record last updated: October 20, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Oct 20, 2022, Dec 10, 2018 (2 updates tracked since 2018).

About Kim Tatum Aprn NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KIM TATUM APRN (NPI 1073005419) is an individual family provider in Las Vegas, Nevada, licensed in Nevada (APRN002919) and active in the NPI registry since June 2018. She is enrolled in Medicare PECOS, maintains a secondary practice location in Las Vegas, and is a graduate of Other (2017).

NPPES Registry Identity

NPI1073005419
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameKIM TATUMCredential: APRN
Location Address9454 DEL WEBB BLVDLas Vegas, NV 89134-8314
Mailing Address6355 S Buffalo Dr Fl 3Las Vegas, NV 89113-2133 · (702) 216-3346 · Fax (702) 671-6883
Phone(702) 940-1580
Fax(702) 940-1581
Sole ProprietorNo
Medical School CMSOtherGraduated 2017
Enumeration DateJune 1, 2018
Last NPPES UpdateOctober 20, 20222 updates tracked since enumeration
NPPES CertifiedOctober 20, 2022
✔ NPI 1073005419 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in NV · APRN002919
9454 DEL WEBB BLVD, Las Vegas, NV 89134
Open in Google Maps ↗

Secondary Practice Location 1

Location 14500 W Oakey BlvdLas Vegas, NV 89102-1527 · Phone (702) 873-5110 · Fax (702) 873-8093

Other Identifiers 2

OtherAPRN002919NV · State License
Medicaid1073005419NV

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kim Tatum Aprn is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4284972480
PECOS Enrollment IDI20190213002956
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Kim Tatum reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Intermountain Medical Holdings Nevada Inc
21 mi
Internal Medicine
595 W LAKE MEAD PKWY
Henderson, NV 89015
  • Reassigned Medicare billing, Nevada enrollment
  • 521 clinicians in this Medicare group
NPI 1245997279 (702) 566-5500

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 89134 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$88.51 typical visit price
range $57.07 – $173.24
Typical copayment $22.12 (range $14.26 – $43.31)
Most-billed visit code 99203
Established Patient
$100.60 typical visit price
range $18.27 – $140.96
Typical copayment $25.15 (range $4.56 – $35.24)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ANJALI A REGE MD
Family Medicine
9454 DEL WEBB BLVD
LAS VEGAS, NV 89134
Clark County (702) 940-1580

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kim Tatum's NPI number?

The NPI number for Kim Tatum is 1073005419. It was assigned to this individual provider in the NPPES registry on June 1, 2018.

Where is Kim Tatum located?

Kim Tatum practices at 9454 Del Webb Blvd, Las Vegas, NV 89134. The listed phone number is (702) 940-1580.

What is Kim Tatum's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Kim Tatum enrolled in Medicare?

Yes. Kim Tatum is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Kim Tatum's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kim Tatum reassigns Medicare benefits to Intermountain Medical Holdings Nevada Inc (Henderson, NV). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kim Tatum's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Kim Tatum was last updated on October 20, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.