Jiva Marie Pate, APRN

Primary specialty

Adult Medicine PhysicianTaxonomy code 207QA0505X

License

AP139482 Issued in TX

Practice address

2912 Avenue E
Hondo, TX 78861-3329

Phone

(830) 426-5288

Fax

(830) 426-5290

NPI assigned

Feb 19, 2018

Last updated

Aug 29, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/15827/brand/1/csg/1/fhir/r4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Willis Clinic

  dba Willis Clinic PLLC

  • Primary Care Clinic/Center
  • Osceola, AR
  • NPI 1063619567
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1518998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693267200000",
    "number": "1053811752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2912 AVENUE E",
            "city": "HONDO",
            "state": "TX",
            "postal_code": "788613329",
            "telephone_number": "830-426-5288",
            "fax_number": "830-426-5290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2912 AVENUE E",
            "city": "HONDO",
            "state": "TX",
            "postal_code": "788613329",
            "telephone_number": "830-426-5288",
            "fax_number": "830-426-5290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATE",
        "first_name": "JIVA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-02-19",
        "last_updated": "2023-08-29",
        "certification_date": "2023-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "TX",
            "license": "AP139482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ahmad Nawaz
• Lisa Marie Nolan, PA-C
• Kris Noonan
• Orion Emergency Physicians, PLLC
• Karen Lynn Ottinger, CRNA
• Francesca Piccioni, LPC
• Preferred Care Health Facilities of Texas I Inc (Community Care Center)
• Promise Senior Solutions
• Pure Life LLC (Gods Country Primary Home Care Services)
• Amanda Ralph, MSN, APRN, FNP-C

• Adult Medicine Physician in Hondo, TX
• Providers in Hondo, TX by specialty
• Adult Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.