Individual provider Active NPI

Georganna Pate, CRNP

  • Pediatric Nurse Practitioner
  • Foley, AL
National Provider Identifier
1235476938
Registry record updated Jan 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
1-056278 Issued in AL
Practice address
106 W Myrtle Ave
Foley, AL 36535-1935
Phone
(251) 943-5437
Fax
(251) 943-3227
NPI assigned
Jan 15, 2013
Last updated
Jan 26, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 26, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 1-056278 AL Primary

Addresses

Primary practice location

106 W Myrtle Ave
Foley, AL 36535-1935

Mailing address

106 W Myrtle Ave
Foley, AL 36535-1935
Phone (251) 943-5437

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20170214002481 FL Practitioner - Nurse Practitioner 0941583165 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1-056278ALMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Panhandle Emergency Physicians a Div of Sacred Heart Hosp Pensacola CurrentSince Dec 14, 2016 Accepting new patients
Coastal Pediatrics LLC PastSince Feb 11, 2024 Accepting new patients

Locations

5151 N 9th Ave
Pensacola, FL 32504
Phone (850) 202-4700

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1358208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453766400000",
    "number": "1235476938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 W MYRTLE AVE",
            "city": "FOLEY",
            "state": "AL",
            "postal_code": "365351935",
            "telephone_number": "251-943-5437",
            "fax_number": "251-943-3227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 W MYRTLE AVE",
            "city": "FOLEY",
            "state": "AL",
            "postal_code": "365351935",
            "telephone_number": "251-943-5437",
            "fax_number": "251-943-3227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATE",
        "first_name": "GEORGANNA",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-01-15",
        "last_updated": "2016-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "AL",
            "license": "1-056278",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Foley, AL

Sources for this page

Verify at the official NPI Registry.