Bryan D. Tate Jr., FNP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

AP06135 Issued in LA

Practice address

919 Avenue G
Kentwood, LA 70444

Phone

(985) 229-0202

Fax

(985) 229-2859

NPI assigned

Jun 15, 2010

Sex

Male

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 1

Medicare fee-for-service enrollment

Enrolled in LA

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 1

Specialty

Nurse Practitioner

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Independence Family Clinic, LLCGroup PAC ID 1951845494, 2 clinicians

Kentwood Family Clinic LLCGroup PAC ID 4082923099, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Audubon Home Health of Hammond Home health agency, Hammond, LA, CCN 197272
• Pulse Home Health Care Home health agency, Covington, LA, CCN 197179
• Hood Memorial Hospital Hospital, Amite, LA, CCN 191309
• Womans Hospital Hospital, Baton Rouge, LA, CCN 190128
• North Oaks Medical Center Hospital, Hammond, LA, CCN 190015

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Independence Family Clinic LLC

  • Rural Health Clinic/Center
  • Independence, LA
  • NPI 1922876960

  5% Or Greater Direct Ownership Interest, W-2 Managing Employee

  CMS ownership
• Kentwood Family Clinic LLC

  • Rural Health Clinic/Center
  • Kentwood, LA
  • NPI 1780050294

  5% Or Greater Direct Ownership Interest, Corporate Officer, Operational/Managerial Control

  CMS ownership

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.

• Independence Family Clinic LLC

  • Rural Health Clinic/Center
  • Independence, LA
  • NPI 1922876960
  Medicare reassignment Care Compare group NPD Authorized official
• Kentwood Family Clinic LLC

  • Rural Health Clinic/Center
  • Kentwood, LA
  • NPI 1780050294

  Nurse Practitioner

  Medicare reassignment Care Compare group NPD
• Schilling Health LLC

  • Health Service Clinic/Center
  • Kentwood, LA
  • NPI 1710693437
  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• BGM Group, LLC

  • Home Health Agency
  • Covington, LA
  • NPI 1821044165
  Care Compare affiliation
• Capital Region Home Health Inc

  • Home Health Agency
  • Hammond, LA
  • NPI 1750729760
  Care Compare affiliation
• Hood Memorial Hospital

  • Psychiatric Hospital Unit
  • Amite, LA
  • NPI 1649460122
  Care Compare affiliation
• Hospital Service District 2 of the Parish of Tangipahoa State of la.

  • Critical Access Hospital
  • Amite, LA
  • NPI 1003925959
  Care Compare affiliation
• North Oaks Medical Center, LLC

  • Rural Acute Care Hospital
  • Hammond, LA
  • NPI 1144227539
  Care Compare affiliation
• Woman'S Hospital Foundation

  • General Acute Care Hospital
  • Baton Rouge, LA
  • NPI 1912943184
  Care Compare affiliation

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

{
    "created_epoch": "1276560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455840000000",
    "number": "1407177348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75136 N RIVER RD",
            "city": "KENTWOOD",
            "state": "LA",
            "postal_code": "704443800",
            "telephone_number": "985-229-0202",
            "fax_number": "985-229-2859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "919 AVENUE G",
            "city": "KENTWOOD",
            "state": "LA",
            "postal_code": "70444",
            "telephone_number": "985-229-0202",
            "fax_number": "985-229-2859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TATE",
        "first_name": "BRYAN",
        "middle_name": "D.",
        "name_suffix": "Jr.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-15",
        "last_updated": "2016-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "LA",
            "license": "RN102323 AP06135",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "LA",
            "license": "AP06135",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2115014",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Southeast Community Health Systems
• Southeast Community Health Systems
• Southeast Community Health Systems Pharmacy Kentwood
• Anthony Spitale
• Jennifer St. Romain, CPNP
• TKJ Healthcare LLC
• Troy M. Verges DDS Inc.
• Terry Scott Turner, DDS
• Wal-Mart Stores East LP
• Daryl Marshall Westmoreland Sr., D.D.S.

• Nurse Practitioner in Kentwood, LA
• Providers in Kentwood, LA by specialty
• Nurse Practitioner in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• 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.