Active NPI
Connie E Tate, L.M.T.
- Contractor
- Greenville, SC
National Provider Identifier
1346485828
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Contractor
- License
- 4898
- Practice address
- 17 Lawton Ave
Greenville, SC 29601-2305 - Phone
- (864) 232-7821
- NPI assigned
- Dec 11, 2008
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Contractor | 171W00000X | 4898 | SC | Primary |
Addresses
Primary practice location
17 Lawton Ave
Greenville, SC 29601-2305
Mailing address
205 Pete Hollis Blvd
Greenville, SC 29601-1155
Phone (864) 242-3707
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4898 | SC | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1228953600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1228953600000",
"number": "1346485828",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "205 PETE HOLLIS BLVD",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296011155",
"telephone_number": "864-242-3707"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17 LAWTON AVE",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296012305",
"telephone_number": "864-232-7821"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TATE",
"first_name": "CONNIE",
"middle_name": "E",
"credential": "L.M.T.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-12-11",
"last_updated": "2008-12-11",
"status": "A"
},
"taxonomies": [
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": "SC",
"license": "4898",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Greenville, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.