Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mark Tatum, CAA

Individual provider Anesthesiologist Assistant · NPI 1396389755

Mark Tatum, CAA is an Anesthesiology Assistant in Canton, Ohio. Qualified in 2019, 7 years ago. Practices with University Primary Care Practices Inc, a 1,073-clinician group and accepts Medicare assignment.

Years since qualifying
7
In the registry since
2019

Practice location Address checks out

1320 Mercy Dr NW
Canton, OH 44708-2641
Phone: (330) 489-1000
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Anesthesiologist Assistant (primary) Taxonomy 367H00000X

Record details

NPI number1396389755
Entity typeIndividual (Type 1)
GenderMale
Credentials CAA
Sole proprietorNo
NPI enumeratedOctober 29, 2019
Last updated in NPPESMarch 8, 2021
Certification dateMarch 8, 2021
Mailing address354 W Mohawk Dr, Malvern, OH 44644-9627

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyANESTHESIOLOGY ASSISTANT
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice University Primary Care Practices Inc — 1073 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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