TATUM JEAN EDDY DO
NPI 1790571834
Student in an Organized Health Care Education/Training Program in Detroit, MI

Q: What is Tatum Eddy's NPI number?

The NPI number for Tatum Eddy is 1790571834. It was assigned to this individual provider in the NPPES registry on April 16, 2025.

Q: What is Tatum Eddy's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Tatum Eddy was last updated on April 16, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months 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.

Active since April 16, 2025PECOS Enrolled

3901 BEAUBIEN ST, DETROIT, MI 48201(313) 745-5437 Get Directions Write a Review

NPPES record last updated: April 16, 2025. Verified against the NPPES registry weekly; last sync: September 06, 2026.

On this page

About Tatum Jean Eddy Do NPPES

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

TATUM JEAN EDDY DO (NPI 1790571834) is an individual student in an organized health care education/training program in Detroit, Michigan and active in the NPI registry since April 2025. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1790571834

Entity TypeIndividualFemale

Primary Taxonomy390200000X

Provider Legal NameTATUM JEAN EDDYCredential: DO

Location Address3901 BEAUBIEN STDetroit, MI 48201-2119

Mailing Address300 Beverly Island DrWaterford, MI 48328-3600 · (248) 214-3015

Phone(313) 745-5437

Sole ProprietorNo

Enumeration DateApril 16, 2025

NPPES CertifiedApril 16, 2025

✔ NPI 1790571834 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

3901 BEAUBIEN ST, Detroit, MI 48201

Open in Google Maps ↗

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Tatum Jean Eddy Do 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.

Other Providers at the Same Location NPPES 20

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

KAROLINA MAKSIMOWSKI

Pediatrics (Pediatric Emergency Medicine)