Individual provider Active NPI

Kristen Victoria Tate, PHYSICAL THERAPIST

  • Physical Therapist
  • Wilmington, DE
National Provider Identifier
1336734136
Registry record updated Apr 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
J1-0014326 Issued in DE
Practice address
701 Foulk Rd Ste 2a
Wilmington, DE 19803-3733
Phone
(877) 407-3422
Fax
(877) 407-4329
NPI assigned
Mar 3, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X J1-0014326 DE Primary

Addresses

Primary practice location

701 Foulk Rd Ste 2a
Wilmington, DE 19803-3733

Mailing address

1050 Industrial Dr Ste 210
Middletown, DE 19709-2803
Phone (302) 389-7855

Other practice location 1

100 S Main St Ste 300
Smyrna, DE 19977-1495
Phone (302) 389-7855

Other names 1

  • Kristen Victoria McMillen Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler Other Fox Rehabilitation Services INC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210316001511 DE Practitioner - Physical Therapist in Private Practice 8426464520 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fox Rehabilitation Services IncGroup PAC ID 0143133009, 1,169 clinicians

Practice addresses (Care Compare)

701 Foulk Rd
2A
Wilmington, DE 19803-3733
Phone (877) 407-3422

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Physical Therapy and Sports Performance Limited Partnership Physical Therapist CurrentSince Mar 8, 2021 Accepting new patients
Fox Rehabilitation Services Inc Physical Therapist CurrentSince Jul 1, 2021 Accepting new patients
Premier Physical Therapy and Sports Performance Limited Partnership CurrentSince Mar 8, 2021 Accepting new patients

Locations

1050 Industrial Dr
Ste 210
Middletown, DE 19709

100 S Main St
Ste 300
Smyrna, DE 19977
Phone (302) 389-7855

701 Foulk Rd
Ste 2A
Wilmington, DE 19803

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1614729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744588800000",
    "number": "1336734136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 INDUSTRIAL DR STE 210",
            "city": "MIDDLETOWN",
            "state": "DE",
            "postal_code": "197092803",
            "telephone_number": "302-389-7855",
            "fax_number": "302-449-2047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 FOULK RD STE 2A",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198033733",
            "telephone_number": "877-407-3422",
            "fax_number": "877-407-4329"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 S Main St Ste 300",
            "address_purpose": "LOCATION",
            "city": "Smyrna",
            "state": "DE",
            "postal_code": "199771495",
            "country_code": "US",
            "telephone_number": "302-389-7855",
            "fax_number": "302-449-2047",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TATE",
        "first_name": "KRISTEN",
        "middle_name": "VICTORIA",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-03",
        "last_updated": "2025-04-14",
        "certification_date": "2025-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "DE",
            "license": "J1-0014326",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.13.34.110.1.998.01",
            "affiliationName": "Fox Rehabilitation Services INC",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "701 Foulk Rd Ste 2A",
            "city": "Wilmington",
            "state": "DE",
            "country_code": "US",
            "postal_code": "198033733",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KRISTEN",
            "last_name": "MCMILLEN",
            "middle_name": "VICTORIA",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Wilmington, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.