Tate Vernon, DO

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

U0678 Issued in TX

Practice address

673 MDG
5955 Zeamer Avenue
Jber, AK 99506

Phone

(907) 580-5556

NPI assigned

Mar 3, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in AK

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

Specialty

Emergency Medicine

Education

Des Moines University of Osteopathic Medicine and Health Sciences, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Matsu Emergency Medicine Physicians CorpGroup PAC ID 1557251022, 18 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mat-Su Regional Medical Center Hospital, Palmer, AK, CCN 020006

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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 and National Provider Directory roles.

• Mat-Su Emergency Medicine Physicians Corp

  • Emergency Medicine Physician
  • Palmer, AK
  • NPI 1073548129
  Medicare reassignment Care Compare group NPD

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

• Mat-Su Valley Medical Center LLC

  • General Acute Care Hospital
  • Palmer, AK
  • NPI 1417975061
  Care Compare affiliation

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

{
    "created_epoch": "1614729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730073600000",
    "number": "1972198836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "673 MDG",
            "address_2": "5955 ZEAMER AVENUE",
            "city": "JBER",
            "state": "AK",
            "postal_code": "99506",
            "telephone_number": "907-580-5556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "673 MDG",
            "address_2": "5955 ZEAMER AVENUE",
            "city": "JBER",
            "state": "AK",
            "postal_code": "99506",
            "telephone_number": "907-580-5556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERNON",
        "first_name": "TATE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-03",
        "last_updated": "2024-10-28",
        "certification_date": "2024-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "TX",
            "license": "U0678",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "U0678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "NA",
            "affiliation": "N",
            "address_1": "3551 Roger Brooke Dr",
            "city": "Fort Sam Houston",
            "state": "TX",
            "country_code": "US",
            "postal_code": "782344504",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Benjamin G Turner, OT
• Robert Fenton Tyree, M.D.
• Susanne K Vanderbilt, M.D.
• Patricia Vassallo, NP
• Bryce Lowell Veazey, LICSW
• Danielle Brooke Veronneau, DO
• Michael Marc Veronneau, D.O.
• Joanne M Villaflor, RD
• Jeffrey Allen Villalpando
• Dennis Dean Walker, DO

• Emergency Medicine Physician in Jber, AK
• Providers in Jber, AK by specialty
• Emergency Medicine Physician in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2024; 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.
• 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.