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MALLORY STEPHENS TATUM P.A.
NPI 1467978403
Physician Assistant in Lakeland, TN

Active since August 22, 2017PECOS Enrolled
9160 HIGHWAY 64 STE 105, LAKELAND, TN 38002(901) 213-0100(901) 213-0101 Get Directions Write a Review

NPPES record last updated: March 26, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Mar 26, 2020, Feb 5, 2019, Jul 12, 2018 and 2 more (5 updates tracked since 2017).

About Mallory Stephens Tatum P.a. NPPES

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

MALLORY STEPHENS TATUM P.A. (NPI 1467978403) is an individual physician assistant in Lakeland, Tennessee, licensed in Tennessee (3352) and active in the NPI registry since August 2017. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1467978403
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameMALLORY STEPHENS TATUMCredential: P.A.
Location Address9160 HIGHWAY 64 STE 105Lakeland, TN 38002-3011
Mailing Address8016 Ellis RdBartlett, TN 38133-2806 · (662) 322-9442
Phone(901) 213-0100
Fax(901) 213-0101
Sole ProprietorNo
Enumeration DateAugust 22, 2017
Last NPPES UpdateMarch 26, 20205 updates tracked since enumeration
NPPES CertifiedMarch 26, 2020
✔ NPI 1467978403 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in TN · 3352
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
9160 HIGHWAY 64 STE 105, Lakeland, TN 38002
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Other Names 1

Former Name (1)Mallory Stephens

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mallory Stephens Tatum P.a. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 38002 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
$81.53 typical visit price
range $52.64 – $160.89
Typical copayment $20.38 (range $13.16 – $40.22)
Most-billed visit code 99203
Established Patient
$66.01 typical visit price
range $16.72 – $131.41
Typical copayment $16.50 (range $4.18 – $32.85)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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 Mallory Tatum's NPI number?

The NPI number for Mallory Tatum is 1467978403. It was assigned to this individual provider in the NPPES registry on August 22, 2017. The provider is also known as Mallory Stephens.

Where is Mallory Tatum located?

Mallory Tatum practices at 9160 Highway 64 Ste 105, Lakeland, TN 38002. The listed phone number is (901) 213-0100.

What is Mallory Tatum's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Mallory Tatum enrolled in Medicare?

Yes. Mallory Tatum is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Mallory Tatum was last updated on March 26, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.