Active NPI
Russell William Pate, CPED
- Pedorthist
- Dublin, CA
National Provider Identifier
1306691597
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pedorthist
- Practice address
- 6483 Sierra LN
Dublin, CA 94568-2797 - Phone
- (925) 820-0220
- NPI assigned
- Apr 22, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pedorthist | 224L00000X | Primary |
Addresses
Primary practice location
6483 Sierra LN
Dublin, CA 94568-2797
Mailing address
6483 Sierra LN
Dublin, CA 94568-2797
Phone (925) 820-0220
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1713744000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1713744000000",
"number": "1306691597",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6483 SIERRA LN",
"city": "DUBLIN",
"state": "CA",
"postal_code": "945682797",
"telephone_number": "925-820-0220"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6483 SIERRA LN",
"city": "DUBLIN",
"state": "CA",
"postal_code": "945682797",
"telephone_number": "925-820-0220"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATE",
"first_name": "RUSSELL",
"middle_name": "WILLIAM",
"credential": "CPED",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-04-22",
"last_updated": "2024-04-22",
"certification_date": "2024-04-21",
"status": "A"
},
"taxonomies": [
{
"code": "224L00000X",
"taxonomy_group": "",
"desc": "Pedorthist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dublin, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.