Sandra Tate, APN, PMNCNS-BC

Primary specialty

Child & Adolescent Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0807X

License

277000849 Issued in IL

Practice address

3412 Office Park Dr
Marion, IL 62959-6477

Phone

(618) 292-9999

Fax

(618) 551-2757

NPI assigned

May 24, 2006

Last updated

Jan 15, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in IL2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/11869/brand/1/csg/1/fhir/r4
• Direct secure messaging: sandra.tate.1@11869.direct.athenahealth.com
• Direct secure messaging: sandra.tate@crhpc.eclinicaldirectplus.com
• Direct secure messaging: state89172@direct-ehr-ssmhc.com

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.

• Christopher Greater Area Rural Health Planning Corporation

  • Federally Qualified Health Center (FQHC)
  • Christopher, IL
  • NPI 1639159213
  Medicare reassignment NPD
• Community Resource Center Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Centralia, IL
  • NPI 1386605434
  Medicare reassignment NPD
• Salem Township Hospital

  • Critical Access Hospital
  • Salem, IL
  • NPI 1295739548
  Medicare reassignment NPD
• Washington County Hospital District

  dba Washington County Hospital

  • Critical Access Hospital
  • Nashville, IL
  • NPI 1659321560
  Medicare reassignment NPD
• Christopher Greater Area Rural Health Planning Corporation

  dba Mt. Vernon Health & Wellness Center

  • Federally Qualified Health Center (FQHC)
  • Mount Vernon, IL
  • NPI 1083592604
  NPD
• Christopher Greater Area Rural Health Planning Corporation

  dba Carrier Mills Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Carrier Mills, IL
  • NPI 1548994817
  NPD
• Community Resource Center Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Carlyle, IL
  • NPI 1538395793
  NPD
• Marshall Browning Hospital Association

  • Critical Access Hospital
  • Du Quoin, IL
  • NPI 1821099441
  NPD
• Marshall Browning Hospital Association

  dba MBH East Medical Clinic

  • Rural Health Clinic/Center
  • Du Quoin, IL
  • NPI 1912490277
  NPD
• Salem Township Hospital

  dba STH Family Health Care Center

  • Rural Health Clinic/Center
  • Salem, IL
  • NPI 1649830472
  NPD
• Washington County Hospital District

  dba Washington County Hospital Walk In Clinic

  • Rural Health Clinic/Center
  • Nashville, IL
  • NPI 1316555816
  NPD
• Crossroads Physicians Corp

  • Family Medicine Physician
  • Mount Vernon, IL
  • NPI 1508850520

  Nurse Practitioner

  NPD (past)

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

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768435200000",
    "number": "1326093493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 MEDLIN RD",
            "city": "CENTRALIA",
            "state": "IL",
            "postal_code": "628019531",
            "telephone_number": "618-292-9999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3412 OFFICE PARK DR",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629596477",
            "telephone_number": "618-292-9999",
            "fax_number": "618-551-2757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TATE",
        "first_name": "SANDRA",
        "credential": "APN, PMNCNS-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-24",
        "last_updated": "2026-01-15",
        "certification_date": "2026-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0807X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Child & Adolescent",
            "state": "IL",
            "license": "277000849",
            "primary": true
        },
        {
            "code": "364SP0808X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": "IL",
            "license": "277-000849",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE NUMBER",
            "identifier": "P00220754",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP",
            "identifier": "207988",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR GROUP NUMBER",
            "identifier": "CG2264",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathryn Swinford, PTA
• Angelito Dariel Tacderas, APN
• Valerie L Tallman, M.S.
• Weiyi Tang, MD
• Sarah Ali Tariq, DO
• Brian Thomas Taylor, P.T.
• Guinevere Shay Rose Taylor, RN
• Jaleigh Brieann Taylor
• Kathy Taylor, MA
• Sheri Lynne Taylor, BC-HIS

• Child & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist in Marion, IL
• Providers in Marion, IL by specialty
• Child & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2026; 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.