Melissa Fanning Tate, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

06400 Issued in LA

Practice address

19089 Florida Blvd
Albany, LA 70711-3603

Phone

(225) 209-7140

NPI assigned

Aug 25, 2011

Last updated

Jan 18, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

360 Therapy LLCGroup PAC ID 7416247713, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• 360 Therapy, LLC

  dba 360 Therapy

  • Physical Therapy Clinic/Center
  • Albany, LA
  • NPI 1992199657

  Physical Therapist

  Medicare reassignment Care Compare group NPD Authorized official
• Family Healthcare of Loranger, LLC

  • Rural Health Clinic/Center
  • Loranger, LA
  • NPI 1992172621
  NPD

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

{
    "created_epoch": "1314230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642464000000",
    "number": "1740560481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1536",
            "city": "ALBANY",
            "state": "LA",
            "postal_code": "707111536",
            "telephone_number": "985-320-0264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19089 FLORIDA BLVD",
            "city": "ALBANY",
            "state": "LA",
            "postal_code": "707113603",
            "telephone_number": "225-209-7140"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "54033 Highway 1062 Ste B",
            "address_purpose": "LOCATION",
            "city": "Loranger",
            "state": "LA",
            "postal_code": "704463538",
            "country_code": "US",
            "telephone_number": "225-209-7140",
            "fax_number": "225-567-6847",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TATE",
        "first_name": "MELISSA",
        "middle_name": "FANNING",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-25",
        "last_updated": "2022-01-18",
        "certification_date": "2022-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "LA",
            "license": "06400",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "LA",
            "license": "06400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bobbi Gwen Smith
• John Henry Smith
• Sarah Elaine Spano, PHARMD
• Emily Spurgeon, M.S., L-SLP, CCC-SLP
• St Michael Hospice, LLC
• Kimberly Thai, DC
• Sharmon P Thompson, RN
• Shelbi Vickers
• Richard Wale
• Ashley Durbin Wells, MS CCC-SLP L-SLP

• Physical Therapist in Albany, LA
• Providers in Albany, LA by specialty
• Physical Therapist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.