ALICIA PATE (NPI# 1457358913) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457358913 |
| Entity Type | Individual |
| Full Name | ALICIA PATE |
| Credential | PA |
| Practice Address |
3900 St Francis Way Ste 201 Lafayette IN 47905-4923 |
| Mailing Address |
8840 Commerce Park Pl Ste E Indianapolis IN 46268-3129 |
| Practice Telephone | 7654467981 |
| Enumeration Date | 2005-06-30 |
| Last Update Date | 2014-12-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
10001351A | IN | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
085002324 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
10001351A | IN | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
08502324 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | ANTHEM PROVIDER NUMBER | 000000741060 | 01 |
| MO | LICENSE | 2005016213 | 01 |
| IL | LICENSE | 085002324 | 01 |
| Street Address |
3900 ST FRANCIS WAY STE 201 |
| City | LAFAYETTE |
| State | IN |
| Zip Code | 47905-4923 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871010678 | Kate Dell | Nurse Practitioner | 3900 St Francis Way Ste 201, Lafayette, IN 47905-4925 | 2017-08-23 |
| 1740664390 | Margaret Ann Mitchel | Nurse Practitioner | 3900 St Francis Way Ste 201, Lafayette, IN 47905-4923 | 2015-07-14 |
| 1205218914 | Amanda Murray | Physician Assistant | 3900 St Francis Way Ste 201, Lafayette, IN 47905-4923 | 2015-06-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538719893 | Elements Counseling LLC | Social Worker | 115 N. Farabee Drive, Lafayette, IN 47905 | 2019-09-18 |
| 1134596869 | Indiana Dental Sleep Therapy LLC | Dentist | 4921 Sr 26 E, Suite 300, Lafayette, IN 47905 | 2015-08-28 |
| 1255750899 | Emily S Miller | Physical Therapist | 1701 Creasy Ln, Lafayette, IN 47905 | 2014-04-10 |
| 1073876215 | Nathan Webster | Dentist | 1530 Kossuth St., Lafayette, IN 47905 | 2012-06-22 |
| 1578848370 | Mark Jin Kim | Pharmacist | 1801 South St., Lafayette, IN 47905 | 2011-10-13 |
| 1700177185 | Shannon Tawn Harris | Speech-Language Pathologist | 8900 Cobbler Lane, Lafayette, IN 47905 | 2011-04-20 |
| 1508164484 | David Thomas Beine | Specialist/Technologist | 1321 Unity Pl Ste A, Lafayette, IN 47905 | 2011-03-02 |
| 1447569538 | Deidre Dudley | Nurse Practitioner | 1701 S Creasy Ln Ste 1w93, Lafayette, IN 47905 | 2010-10-07 |
| 1548493067 | Unity Healthcare, LLC | Podiatrist | 750 Park East Blvd, Unit 4, Lafayette, IN 47905 | 2009-09-01 |
| 1073762969 | Lynette Marie Alexander | Nurse Practitioner | 5500 St Rd. 38 East, Lafayette, IN 47905 | 2008-09-16 |
| Find all providers in zip 47905 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033737366 | Wound Solutions Inc | Physician Assistant | 130 Old Laramie Trl Ste 100, Lafayette, CO 80026-7014 | 2020-07-13 |
| 1558685495 | Douglas D Kesler | Physician Assistant | 1411 S Creasy Lane, Suite 120, Lafayette, IN 47905-7433 | 2010-03-22 |
| 1285895060 | Jennifer Menard Piker | Physician Assistant | 605 Silverstone Road, Suite 100, Lafayette, LA 70508 | 2008-06-24 |
| 1013019108 | Tabatha Alma Tomajko | Physician Assistant | 300 Exempla Circle, Suite 360, Bluestone Advanced Surgical Care, Lafayette, CO 80026 | 2006-09-01 |
| 1437134707 | Cal Anthony Domingue | Physician Assistant | 5000 Ambassador Caffery Pkwy Bldg 14a, Lafayette, LA 70508-6984 | 2005-12-09 |
| 1811997075 | James R. Redmond Sr. | Physician Assistant | 601 W Saint Mary Blvd, Ste 308, Lafayette, LA 70506-3568 | 2005-07-28 |
| 1326694076 | Nathan J Ambrose | Physician Assistant | 5000 Ambassador Caffery Pkwy Ste A, Lafayette, LA 70508-6984 | 2019-08-16 |
| 1720536618 | Richard Davis | Physician Assistant | 5000 Ambassador Caffery Pkwy Ste A, Lafayette, LA 70508-6984 | 2016-09-20 |
| 1205218914 | Amanda Murray | Physician Assistant | 3900 St Francis Way Ste 201, Lafayette, IN 47905-4923 | 2015-06-18 |
| 1245666254 | Emily Renee Thibodaux | Physician Assistant | 1103 Kaliste Saloom Rd, Suite 206, Lafayette, LA 70508-5783 | 2013-09-23 |
| Find all providers in LAFAYETTE | ||||
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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.