Individual provider Active NPI

Joseph L Tate, MD

  • Obstetrics & Gynecology Physician
  • Norcross, GA
National Provider Identifier
1821190919
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
023237 Issued in GA
Practice address
4045 Wetherburn Way
Norcross, GA 30092-1893
Phone
(770) 449-8171
Fax
(770) 449-5015
NPI assigned
Sep 1, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 023237 GA Primary

Addresses

Primary practice location

4045 Wetherburn Way
Norcross, GA 30092-1893

Mailing address

4045 Wetherburn Way
Norcross, GA 30092-1893
Phone (770) 449-8171

Other identifiers 1

IdentifierTypeStateIssuer
00309361AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041108000898 GA Practitioner - Obstetrics/Gynecology 6204899503 Practice locations: Norcross, GA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
023237GAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Crawford Long Hospital Past Accepting new patients
Dekalb-Gwinnett OB/GYN PC Obstetrics & Gynecology 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1821190919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4045 WETHERBURN WAY",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300921893",
            "telephone_number": "770-449-8171",
            "fax_number": "770-449-5015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4045 WETHERBURN WAY",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300921893",
            "telephone_number": "770-449-8171",
            "fax_number": "770-449-5015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TATE",
        "first_name": "JOSEPH",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "GA",
            "license": "023237",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00309361A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norcross, GA

Sources for this page

Verify at the official NPI Registry.