Individual provider Active NPI

Tarah Danielle Slate, NP

  • Family Nurse Practitioner
  • North Dinwiddie, VA
National Provider Identifier
1235951484
Registry record updated Oct 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024191254 Issued in VA
Practice address
25309 Walkers Landing CT
North Dinwiddie, VA 23803-6575
Phone
(804) 720-2837
NPI assigned
Oct 29, 2024
Last updated
Oct 29, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0024191254 VA Primary

Addresses

Primary practice location

25309 Walkers Landing CT
North Dinwiddie, VA 23803-6575

Mailing address

25309 Walkers Landing CT
North Dinwiddie, VA 23803-6575
Phone (804) 720-2837

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250328002416 VA Practitioner - Nurse Practitioner 6901329044 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0024191254VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Signify Health, LLC CurrentSince Jan 1, 2025 Accepting new patients
Recorian Wellness Services, LLC Past Accepting new patients

Locations

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

4055 Valley View Ln
Ste 700
Dallas, TX 75244
Phone (469) 466-7420

1806 Summit Ave
Richmond, VA 23230
Phone (213) 433-2823

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": "1730160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730160000000",
    "number": "1235951484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25309 WALKERS LANDING CT",
            "city": "NORTH DINWIDDIE",
            "state": "VA",
            "postal_code": "238036575",
            "telephone_number": "804-720-2837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25309 WALKERS LANDING CT",
            "city": "NORTH DINWIDDIE",
            "state": "VA",
            "postal_code": "238036575",
            "telephone_number": "804-720-2837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLATE",
        "first_name": "TARAH",
        "middle_name": "DANIELLE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-29",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024191254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Dinwiddie, VA

Sources for this page

Verify at the official NPI Registry.