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SANDERICKA TATUM PMHNP-BC
NPI 1891500922
Nurse Practitioner - Psychiatric/Mental Health in Jacksonville, AR

Active since February 07, 2025PECOS Enrolled
1300 BRADEN ST, JACKSONVILLE, AR 72076(501) 453-6950 Get Directions Write a Review

NPPES record last updated: May 4, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: May 4, 2026, Aug 12, 2025, Feb 15, 2025 and 1 more (4 updates tracked since 2025).

About Sandericka Tatum Pmhnp-bc NPPES

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

SANDERICKA TATUM PMHNP-BC (NPI 1891500922) is an individual psychiatric/mental health provider in Jacksonville, Arkansas, licensed in Arkansas (230744) and active in the NPI registry since February 2025. She is enrolled in Medicare PECOS and is a graduate of Other (2024).

NPPES Registry Identity

NPI1891500922
Entity TypeIndividualFemale
Primary Taxonomy363LP0808X
Provider Legal NameSANDERICKA TATUMCredential: PMHNP-BC
Location Address1300 BRADEN STJacksonville, AR 72076-3719
Mailing Address1300 Braden StJacksonville, AR 72076-3719 · (501) 453-6950
Phone(501) 453-6950
Sole ProprietorYes
Medical School CMSOtherGraduated 2024
Enumeration DateFebruary 7, 2025
Last NPPES UpdateMay 4, 20264 updates tracked since enumeration
NPPES CertifiedMay 4, 2026
✔ NPI 1891500922 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License✔ Licensed in AR · 230744
1300 BRADEN ST, Jacksonville, AR 72076
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Arkansas Blue Cross and Blue Shield, Blue Cross and Blue Shield of Texas, Health Advantage and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Sandericka Tatum Pmhnp-bc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID5991225732
PECOS Enrollment IDI20250224000694
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 Reassignments

3

Medicare enrollment records show Sandericka Tatum reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

White County Medical Center
6.3 mi
Family Medicine
2251 BILL FOSTER MEMORIAL HWY # B
Cabot, AR 72023
  • Reassigned Medicare billing, Arkansas enrollment
  • 159 clinicians in this Medicare group
NPI 1043784366 (501) 941-3345
Unity Health - Newport
70 mi
Psychiatry
1117 MCLAIN ST STE 300
Newport, AR 72112
  • Reassigned Medicare billing, Arkansas enrollment
  • 67 clinicians in this Medicare group
NPI 1164152815 (870) 495-1260
Supportive Psych Care Of Arkansas PA
164 mi
Psychiatry
811 W ELGIN ST
Siloam Springs, AR 72761
  • Reassigned Medicare billing, Arkansas enrollment
  • 78 clinicians in this Medicare group
NPI 1437887437 (718) 298-2753

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 72076 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
$79.72 typical visit price
range $51.36 – $157.74
Typical copayment $19.93 (range $12.84 – $39.43)
Most-billed visit code 99203
Established Patient
$91.63 typical visit price
range $16.16 – $128.77
Typical copayment $22.90 (range $4.04 – $32.19)
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 20

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

MIRIAM GWENYTH MORSE MD
Family Medicine
1300 BRADEN ST
JACKSONVILLE, AR 72076
Pulaski County (501) 985-5900
JOHN GLENN
Physical Therapist
1300 BRADEN ST
JACKSONVILLE, AR 72076
Pulaski County (501) 743-6855
CAMERON JONES M.D.
Family Medicine
1300 BRADEN ST
JACKSONVILLE, AR 72076
Pulaski County (501) 985-5900
JASON JOHNSON P.T.
Physical Therapist
1300 BRADEN ST
JACKSONVILLE, AR 72076
Pulaski County (501) 743-6855
ROBERT ROSS RITCHIE MD
Family Medicine
1300 BRADEN ST
JACKSONVILLE, AR 72076
Pulaski County (501) 985-5900
MS. PATRICIA D SNOW LCSW
Social Worker (Clinical)
1300 BRADEN ST
JACKSONVILLE, AR 72076
Pulaski County (501) 453-6000
HIRA EJAZ SHAH M D
Family Medicine
1300 BRADEN ST
JACKSONVILLE, AR 72076
Pulaski County (501) 985-5900
RICHARD LEE HAYES MD
Family Medicine
1300 BRADEN ST
JACKSONVILLE, AR 72076
Pulaski County (501) 985-5900

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 Sandericka Tatum's NPI number?

The NPI number for Sandericka Tatum is 1891500922. It was assigned to this individual provider in the NPPES registry on February 7, 2025.

Where is Sandericka Tatum located?

Sandericka Tatum practices at 1300 Braden St, Jacksonville, AR 72076. The listed phone number is (501) 453-6950.

What is Sandericka Tatum's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Sandericka Tatum enrolled in Medicare?

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

Which organizations bill Medicare for Sandericka Tatum's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Sandericka Tatum reassigns Medicare benefits to 3 organizations: White County Medical Center (Cabot, AR), Unity Health - Newport (Newport, AR) and Supportive Psych Care Of Arkansas PA (Siloam Springs, AR). Each 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 Sandericka Tatum's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Sandericka Tatum accept?

Health plans from Arkansas Blue Cross and Blue Shield, Blue Cross and Blue Shield of Texas, Health Advantage and Octave list Sandericka Tatum as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Sandericka Tatum was last updated on May 4, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.