NPIMap

Individual provider Active NPI

Tonna D. Pate, PSYD

  • Clinical Psychologist
  • Ruidoso, NM
National Provider Identifier
1548575772
Registry record updated Aug 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
1269 Issued in NM
Practice address
1096 Mechem Dr
Suite 208
Ruidoso, NM 88345-7067
Phone
(575) 808-8018
NPI assigned
Aug 12, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 22, 2013

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 34160 TX
Clinical Child & Adolescent Psychologist 103TC2200X 34160 TX
Forensic Psychologist 103TF0200X 34160 TX
Clinical Psychologist 103TC0700X 1269 NM Primary
Forensic Psychologist 103TF0200X 1269 NM
Clinical Child & Adolescent Psychologist 103TC2200X 1269 NM

Addresses

Primary practice location

1096 Mechem Dr
Suite 208
Ruidoso, NM 88345-7067

Mailing address

1096 Mechem Dr
Suite 208
Ruidoso, NM 88345-7067
Phone (575) 808-8018

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

State licenses

LicenseStateTypeSpecialty
1269NMMDPeriodontist
34160TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Pate Psychological Services PLLC PastSince Sep 12, 2010 Accepting new patients
Tonna D. Pate, PSYD Past Accepting new patients

Organizations & group practices 2

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": "1281571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377129600000",
    "number": "1548575772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1096 MECHEM DR",
            "address_2": "SUITE 208",
            "city": "RUIDOSO",
            "state": "NM",
            "postal_code": "883457067",
            "telephone_number": "575-808-8018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1096 MECHEM DR",
            "address_2": "SUITE 208",
            "city": "RUIDOSO",
            "state": "NM",
            "postal_code": "883457067",
            "telephone_number": "575-808-8018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATE",
        "first_name": "TONNA",
        "middle_name": "D.",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-12",
        "last_updated": "2013-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "34160",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "TX",
            "license": "34160",
            "primary": false
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "TX",
            "license": "34160",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NM",
            "license": "1269",
            "primary": true
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "NM",
            "license": "1269",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "NM",
            "license": "1269",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ruidoso, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.