ANTONIANNETTE PATE (NPI# 1265947451) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265947451 |
| Entity Type | Individual |
| Full Name | ANTONIANNETTE PATE |
| Credential | FNP-C |
| Practice Address |
1750 E Lake Shore Dr Decatur IL 62521-3803 |
| Mailing Address |
Po Box 193 Boody IL 62514-0193 |
| Practice Telephone | 2174641440 |
| Mailing Telephone | 2178535661 |
| Enumeration Date | 2017-12-10 |
| Last Update Date | 2017-12-10 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
209.016156 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1750 E LAKE SHORE DR |
| City | DECATUR |
| State | IL |
| Zip Code | 62521-3803 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285621516 | Jon Fredrick Petersen | Family Medicine | 1750 E Lake Shore Dr, Decatur, IL 62521-3803 | 2005-10-03 |
| 1578093225 | Jason Blanchetti | Nurse Practitioner | 1750 E Lake Shore Dr, Decatur, IL 62521-3803 | 2017-06-15 |
| 1992182331 | Alyson Webb | Nurse Practitioner | 1750 E Lake Shore Dr, Ste 310, Decatur, IL 62521-3803 | 2015-05-06 |
| 1932527017 | Adills Moosa | Preventive Medicine | 1750 E Lake Shore Dr, Decatur, IL 62521-3803 | 2014-04-04 |
| 1841579026 | Justin William Kierbs | Nurse Practitioner | 1750 E Lake Shore Dr, Suite 200, Decatur, IL 62521-3803 | 2011-08-05 |
| 1194012260 | Nikesh Lath | Surgery | 1750 E Lake Shore Dr, Decatur, IL 62521-3803 | 2011-07-08 |
| 1922319839 | Chinelo C Echeazu | Obstetrics & Gynecology | 1750 E Lake Shore Dr, Suite 110, Decatur, IL 62521 | 2010-06-24 |
| 1215267596 | Vikram S Kotwal | Internal Medicine | 1750 E Lake Shore Dr, Suite 310, Decatur, IL 62521-3803 | 2010-01-08 |
| 1396073813 | Mohammed A. Rahman | Neurological Surgery | 1750 E Lake Shore Dr, 110, Decatur, IL 62521-3803 | 2009-11-20 |
| 1750617007 | Randi Rigsby | Nurse Practitioner | 1750 E Lake Shore Dr, Suite 100, Decatur, IL 62521-3803 | 2009-10-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053927988 | Caleb David Braasch | Pharmacist | 1818 South Airport Rd, Decatur, IL 62521 | 2020-09-16 |
| 1295390490 | Crossing Recovery Center | Substance Abuse Rehabilitation Facility | Crossing Recovery Center, 495 East Central Ave, Decatur, IL 62521 | 2019-05-03 |
| 1396300638 | Crossing Recovery Center | Substance Abuse Rehabilitation Facility | 495 E Central Ave, Decatur, IL 62521 | 2019-05-02 |
| 1679138911 | Crossing Recovery Center | Substance Abuse Rehabilitation Facility | 495 East Central Ave, Decatur, IL 62521 | 2019-05-02 |
| 1154848034 | Zack Shaw | Physical Therapist | 4855-57 East 36, Decatur, IL 62521 | 2017-08-23 |
| 1790032852 | Prashant Morolia | Family Medicine | 4775 E Maryland St, Decatur, IL 62521 | 2012-08-08 |
| 1003188913 | Evergreen Place Decatur, LLC | Assisted Living Facility | 4825 E Evergreen Court, Decatur, IL 62521 | 2012-02-08 |
| 1104133099 | Suzette Marie Shafer | Occupational Therapy Assistant | 1790 S. Fairview Ave., Decatur, IL 62521 | 2010-09-13 |
| 1467784090 | Community Health Improvement Center | Clinic/Center | 1221 East Condit Street, Decatur, IL 62521 | 2010-02-08 |
| 1982839056 | Kelly Clark Dds PC | Dentist | 3737 Us Rt 36 E, Decatur, IL 62521 | 2009-05-19 |
| Find all providers in zip 62521 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134729965 | Jamie Mclemore | Nurse Practitioner | 17619 Hwy 58 North, Decatur, TN 37322-3732 | 2020-10-30 |
| 1790383776 | Angela Tope Adeleke | Nurse Practitioner | 3185 Georgian Woods Cir, Decatur, GA 30034-5105 | 2020-10-13 |
| 1417564147 | Jigna Patel | Nurse Practitioner | 1963 Don Juan Ln, Decatur, GA 30032-4218 | 2020-09-27 |
| 1659983856 | Emilie Carsell Mathias | Nurse Practitioner | 2208 N Crossing Way, Decatur, GA 30033-4175 | 2020-08-19 |
| 1275151078 | Tiffanie Marshall Mcguire | Nurse Practitioner | 2042 Beltline Rd Sw Ste B101, Decatur, AL 35601-5571 | 2020-07-08 |
| 1922623610 | Anastasiya A Drogoul | Nurse Practitioner | 2675 N Decatur Rd Ste 404, Decatur, GA 30033-6133 | 2020-06-09 |
| 1174156244 | Anne Marie Strickland | Nurse Practitioner | 3109 Vicksburg Pl Sw, Decatur, AL 35603-3107 | 2020-02-18 |
| 1174161822 | Allison Leanne Hall | Nurse Practitioner | 304 W Hay St Ste 312, Decatur, IL 62526-4170 | 2019-12-12 |
| 1396387866 | Elizabeth Nichole Mathews | Nurse Practitioner | 2301 S Fm 51 Ste 100, Decatur, TX 76234-3864 | 2019-10-16 |
| 1861040479 | Oladunni Funmi Faminu | Nurse Practitioner | 2701 N Decatur Rd # 2400, Decatur, GA 30033-5918 | 2019-08-27 |
| Find all providers in DECATUR | ||||
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| 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.