Active NPI
David M Tate, MD
- Internal Medicine Physician
- Salem, OR
National Provider Identifier
1457397804
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- MD15094
- Practice address
- 2020 Capitol St NE
Salem, OR 97301 - Phone
- (503) 399-2470
- Fax
- (503) 375-7429
- NPI assigned
- Jun 22, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | MD15094 | OR | Primary |
Addresses
Primary practice location
2020 Capitol St NE
Salem, OR 97301
Mailing address
PO Box 8100
Salem, OR 97303
Phone (503) 399-2470
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 133405 | Medicaid | OR | |
| P00248257 | Other | RAILROAD MEDICARE | |
| CS4159 | Other | RAILROAD GROUP |
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)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150934400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1274918400000",
"number": "1457397804",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 8100",
"city": "SALEM",
"state": "OR",
"postal_code": "97303",
"telephone_number": "503-399-2470",
"fax_number": "503-375-7429"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2020 CAPITOL ST NE",
"city": "SALEM",
"state": "OR",
"postal_code": "97301",
"telephone_number": "503-399-2470",
"fax_number": "503-375-7429"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TATE",
"first_name": "DAVID",
"middle_name": "M",
"name_prefix": "Mr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-22",
"last_updated": "2010-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "OR",
"license": "MD15094",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "133405",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00248257",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD GROUP",
"identifier": "CS4159",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Salem, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.