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1356260780 NPI number — DR. ALEXIS FORTE'-TATUM

NPI Number: 1356260780
Health Care Provider/Practitioner: DR. ALEXIS FORTE'-TATUM

Information about “1356260780” NPI (DR. ALEXIS FORTE'-TATUM) exists in 1356260780 in HTML format HTML  |  1356260780 in plain Text format TXT  |  1356260780 in PDF (Portable Document Format) PDF  |  1356260780 in an XML format XML  formats.

NPI Number : 1356260780 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1356260780",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "FORTE'-TATUM",
    "FirstName": "ALEXIS",
    "MiddleName": null,
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "PARKER",
    "OtherFirstName": "ANDREA",
    "OtherMiddleName": null,
    "OtherNamePrefix": "MRS.",
    "OtherNameSuffix": null,
    "OtherCredential": "BSN",
    "OtherLastNameTypeCode": "2",
    "FirstLineMailingAddress": "3056 NEW MACLAND RD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "POWDER SPRINGS",
    "MailingAddressStateName": "GA",
    "MailingAddressPostalCode": "30127-1737",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "678-340-6010",
    "MailingAddressFaxNumber": "678-881-4111",
    "FirstLinePracticeLocationAddress": "3056 NEW MACLAND RD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "POWDER SPRINGS",
    "PracticeLocationAddressStateName": "GA",
    "PracticeLocationAddressPostalCode": "30127-1737",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "678-340-6010",
    "PracticeLocationAddressFaxNumber": "678-881-4111",
    "EnumerationDate": "07/10/2026",
    "LastUpdateDate": "07/10/2026",
    "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": "163WG0600X",
          "TaxonomyName": "Gerontology Registered Nurse",
          "LicenseNumber": "RN169974",
          "LicenseNumberStateCode": "GA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "163WS0200X",
          "TaxonomyName": "School Registered Nurse",
          "LicenseNumber": "RN169974",
          "LicenseNumberStateCode": "GA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "164W00000X",
          "TaxonomyName": "Licensed Practical Nurse",
          "LicenseNumber": "LPN080083",
          "LicenseNumberStateCode": "GA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "174H00000X",
          "TaxonomyName": "Health Educator",
          "LicenseNumber": "RN169974",
          "LicenseNumberStateCode": "GA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "253Z00000X",
          "TaxonomyName": "In Home Supportive Care Agency",
          "LicenseNumber": "RN169974",
          "LicenseNumberStateCode": "GA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "390200000X",
          "TaxonomyName": "Student in an Organized Health Care Education/Training Program",
          "LicenseNumber": "LPN080083",
          "LicenseNumberStateCode": "GA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "246RP1900X",
          "TaxonomyName": "Phlebotomy Technician",
          "LicenseNumber": "LPN080083",
          "LicenseNumberStateCode": "GA",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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