NPI Code Detail JSON Logo

1053971713 NPI number — MELANEY ROSHAUN TATUM C.E.O.

NPI Number: 1053971713
Health Care Provider/Practitioner: MELANEY ROSHAUN TATUM C.E.O.

Information about “1053971713” NPI (MELANEY ROSHAUN TATUM C.E.O.) exists in 1053971713 in HTML format HTML  |  1053971713 in plain Text format TXT  |  1053971713 in PDF (Portable Document Format) PDF  |  1053971713 in an XML format XML  formats.

NPI Number : 1053971713 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1053971713",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "TATUM",
    "FirstName": "MELANEY",
    "MiddleName": "ROSHAUN",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "C.E.O.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "JACKSON",
    "OtherFirstName": "EARNEST",
    "OtherMiddleName": "B",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "C.O.O.",
    "OtherLastNameTypeCode": "2",
    "FirstLineMailingAddress": "6605 HOGUE ST APT 10",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "HOUSTON",
    "MailingAddressStateName": "TX",
    "MailingAddressPostalCode": "77087-6406",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "936-899-8966",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "6605 HOGUE ST APT 10",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "HOUSTON",
    "PracticeLocationAddressStateName": "TX",
    "PracticeLocationAddressPostalCode": "77087-6406",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "936-899-8966",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "06/15/2019",
    "LastUpdateDate": "06/15/2019",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "251G00000X",
          "TaxonomyName": "Community Based Hospice Care Agency",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "171M00000X",
          "TaxonomyName": "Case Manager/Care Coordinator",
          "LicenseNumber": null,
          "LicenseNumberStateCode": "TX",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": {
        "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
        "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
      }
    }
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.