Tristan Tave, DNP, CRNP, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

1-137456 Issued in AL

Practice address

2400 Gordon Smith Dr
Mobile, AL 36617-2319

Phone

(251) 473-4423

NPI assigned

Sep 28, 2015

Last updated

Dec 12, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

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.

• State of Alabama Dept of Mental Health & Mental Retardation

  dba Greil Memorial Psychiatric Hospital

  • Psychiatric Hospital
  • Montgomery, AL
  • NPI 1619190998
  Medicare reassignment NPD
• Mental Health BD of Bibb Pickens and Tuscaloosa Counties

  dba Indian Rivers MHC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Tuscaloosa, AL
  • NPI 1659313393
  NPD

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

{
    "created_epoch": "1443398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481500800000",
    "number": "1538539010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5750A SOUTHLAND DR",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366933316",
            "telephone_number": "251-450-2211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 GORDON SMITH DR",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366172319",
            "telephone_number": "251-473-4423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAVE",
        "first_name": "TRISTAN",
        "credential": "DNP, CRNP, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-09-28",
        "last_updated": "2016-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AL",
            "license": "1-137456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly R Tartt-Godbolt, PSYD
• Kimberly Tarver
• Carmen Tate
• Julia Christine Tatman
• Paul Michael Taupeka, M.D.
• Jennifer Taylor-Guy, AUD., CCC-A
• Ashley Inez Taylor, BCBA, LBA
• Brentley R Taylor, M.D.
• Burt Fowler Taylor, MD
• Debra Taylor, P.T.

• Psychiatric/Mental Health Nurse Practitioner in Mobile, AL
• Providers in Mobile, AL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2016; 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.