Individual provider Active NPI

Katie Jo Moorefield Tate, A-GNP

  • Primary Care Nurse Practitioner
  • Greensboro, NC
National Provider Identifier
1720743404
Registry record updated Feb 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
TATE-ZG5Q3 Issued in NC
Practice address
1511 Westover Ter
Greensboro, NC 27408-7128
Phone
(336) 373-0611
NPI assigned
Nov 8, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP2300X TATE-ZG5Q3 NC Primary

Addresses

Primary practice location

1511 Westover Ter
Greensboro, NC 27408-7128

Mailing address

1511 Westover Ter
Greensboro, NC 27408-7128

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20220224001119 NC Practitioner - Nurse Practitioner 3577957158 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Greensboro Medical Associates, P.a.Group PAC ID 6406751460, 9 clinicians

Practice addresses (Care Compare)

1511 Westover Ter
Suite 201
Greensboro, NC 27408-7131
Phone (336) 373-0611

Hospital & facility affiliations

  • Well Care Home Health of the Triad Inc Home health agency, Advance, NC, CCN 347051

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
TATE-ZG5Q3NCMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Greensboro Medical Associates, P.a. Single Specialty CurrentSince Jan 3, 2022 Accepting new patients

Locations

1511 Westover Ter
Greensboro, NC 27408
Phone (336) 373-0611

1511 Westover Ter
Ste 201
Greensboro, NC 27408
Phone (336) 333-7878

1511 Westover Ter
Ste 20
Greensboro, NC 27408

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BAIIBA
  • Direct secure messaging: katie.tate@gsoma.eclinicaldirectplus.com

Organizations & group practices 1

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1636329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706832000000",
    "number": "1720743404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1511 WESTOVER TER",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274087128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1511 WESTOVER TER",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274087128",
            "telephone_number": "336-373-0611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TATE",
        "first_name": "KATIE",
        "middle_name": "JO MOOREFIELD",
        "credential": "A-GNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-08",
        "last_updated": "2024-02-02",
        "certification_date": "2024-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NC",
            "license": "TATE-ZG5Q3",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

Verify at the official NPI Registry.