DR. KIMBERLY SHAFFER TATE (NPI# 1154418903) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154418903 |
| Entity Type | Individual |
| Full Name | DR. KIMBERLY SHAFFER TATE |
| Credential | PSY.D. |
| Practice Address |
35 Iron Gate Park Dr. Centerville OH 45459-0000 |
| Mailing Address |
Po Box 41158 Centerville OH 45441-0158 |
| Practice Telephone | 9374358864 |
| Practice Fax Number | 9374358264 |
| Mailing Telephone | 9374358864 |
| Mailing Fax Number | 9374358264 |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2007-07-09 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
4664 | OH | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | HUMANA PIN | 172428110968 | 01 |
| OH | ANTHEM PIN | 22000000356767 | 01 |
| OH | MAGELLAN PIN | 028545000 | 01 |
| OH | VALUE OPTIONS | 281859 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851889208 | Kimberly Tate | Counselor | 4110 North Water Place, Mt. Vernon, IL 62864 | 2018-05-01 |
| 1639651771 | Kimberly Ann Tate | Nurse Anesthetist, Certified Registered | 1 Medical Center Blvd, Winston Salem, NC 27157-0001 | 2018-09-05 |
| 1811215734 | Kimberly A Tate | Nurse Practitioner | 1330 N Superior Ave, Tomah, WI 54660-1130 | 2010-05-17 |
| 1750408423 | Kimberly Freeman Tate | Pharmacist | 200 Exempla Cir, Lafayette, CO 80026-3370 | 2007-03-26 |
| Street Address |
35 IRON GATE PARK DR. |
| City | CENTERVILLE |
| State | OH |
| Zip Code | 45459-0000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659917466 | Sarai Burke Robinson | Occupational Therapist | 2200 Miami Valley Rd, Dayton, OH 45459 | 2019-11-27 |
| 1689179855 | Paragon Infusion Therapy, LLC | Durable Medical Equipment & Medical Supplies | 1746 Thomas Paine Pkwy, Centerville, OH 45459 | 2018-03-28 |
| 1922555473 | Hannah Gualtieri | Specialist/Technologist | Miami Valley Drive, Suite 320, Centerville, OH 45459 | 2016-09-01 |
| 1326410028 | Kathleen E Dorsten | Counselor | 37 Irongate Park Dr, Centerville, OH 45459 | 2015-10-21 |
| 1184000846 | Valeriya Falkenshtern | Specialist/Technologist | 2400 Miami Valley Drive, Newborn Hearing Screens, Dayton, OH 45459 | 2015-08-05 |
| 1700169331 | Monica Lynn Carrico | Registered Nurse | 7625 Paragon Road Suite C, Dayton, OH 45459 | 2011-09-20 |
| 1427360080 | Tonia S Campbell | Physical Therapist | 1235 E. Alex Bell Road, Centerville, OH 45459 | 2010-07-11 |
| 1265768956 | Health At Home, LLC | Home Health | 6443 Bethany Village Drive, Dayton, OH 45459 | 2009-10-30 |
| 1881826337 | Annetta Jean Davis | Social Worker | 7950 Clyo Road, Centerville, OH 45459 | 2009-08-18 |
| 1740459783 | Ryan A Long | Dentist | 2591 Miamisburg-centerville Rd, Suite 200, Dayton, OH 45459 | 2008-02-25 |
| Find all providers in zip 45459 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568971455 | Kirsten Harrell | Psychologist | 6966 Wembley Cir, Centerville, OH 45459-6209 | 2017-09-24 |
| 1114391745 | Jeff Eagle | Psychologist | 42 Natka Dr, Centerville, MA 02632-2710 | 2015-11-19 |
| 1033428859 | Jeffrey P Lowery Psychologist PC | Psychologist | 1645 Falmouth Rd Ste 10f, Centerville, MA 02632-2936 | 2010-09-28 |
| 1154466654 | Dene S Berman | Psychologist | 7061 Corporate Way Ste 106, Centerville, OH 45459 | 2007-02-21 |
| 1376631713 | Southwestern Ohio Behavioral Health,llc | Psychologist | 35 Irongate Park Dr, Centerville, OH 45459-4616 | 2006-10-11 |
| 1649386301 | David Anthony Lombard | Psychologist | 2717 Miamisburg-centerville Rd., Suite 218, Centerville, OH 45459 | 2006-08-22 |
| 1447264833 | Ruth E Kauffold | Psychologist | 175 South Main St, Agape Counseling Center, Centerville, OH 45458 | 2006-07-28 |
| 1093756215 | Ronald H Nelson | Psychologist | 1284 Forest Walk Dr, Centerville, OH 45459-4904 | 2006-06-09 |
| 1689626327 | Michael Walker Shields | Psychologist | 1645 Falmouth Rd, Bayberry Square Unit E-3, Centerville, MA 02632-2932 | 2006-05-17 |
| 1003879396 | Success Psych Services, Inc. | Psychologist | 10560 Success Ln, Suite B, Centerville, OH 45458-3697 | 2006-04-08 |
| Find all providers in CENTERVILLE | ||||
| City | CENTERVILLE |
| Zip Code | 45459 |
Please comment or provide details below to improve the information on DR. KIMBERLY SHAFFER TATE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.