Sunja Tate, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R878941 Issued in MS

Practice address

300 Rawls Drive
Suite 100
McComb, MS 39649-2877

Phone

(601) 684-7623

Fax

(877) 795-9891

NPI assigned

Mar 16, 2015

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: sunja.tate.1@23736.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/23736/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 and National Provider Directory roles.

• McComb Children'S Clinic, LTD

  • Pediatrics Physician
  • McComb, MS
  • NPI 1902888316
  NPD (past)

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

{
    "created_epoch": "1426464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439078400000",
    "number": "1124411004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 RAWLS DR",
            "address_2": "SUITE 100",
            "city": "MCCOMB",
            "state": "MS",
            "postal_code": "396482877",
            "telephone_number": "601-684-7623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 RAWLS DRIVE",
            "address_2": "SUITE 100",
            "city": "MCCOMB",
            "state": "MS",
            "postal_code": "396492877",
            "telephone_number": "601-684-7623",
            "fax_number": "877-795-9891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TATE",
        "first_name": "SUNJA",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-03-16",
        "last_updated": "2015-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R878941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dawn M Sumrall, M.D.
• SW Ms Mental Health Mental Retardation Commission
• Imad Tahboub, MD
• Patrick Evan Tarpy, M.D., F.A.A.P.
• Aundrea Chablis Tate
• Betty H Taylor, RN
• Darryl Temple, FNP
• Quiesha Tenner
• Trevor Tennison, PCMHT
• Texas Medical Laboratory Inc

• All providers in McComb, MS
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.