ANN FATE (NPI# 1518396803) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518396803 |
| Entity Type | Individual |
| Full Name | ANN FATE |
| Credential | FNP-C |
| Practice Address |
520 Douglas Blvd Tyler TX 75702-8307 |
| Mailing Address |
Po Box 840698 Dallas TX 75284-0698 |
| Practice Telephone | 9035931721 |
| Mailing Telephone | 9033246450 |
| Enumeration Date | 2013-11-06 |
| Last Update Date | 2019-05-28 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | AP124442 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
661964 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | RAIL ROAD | P01290912 | 01 |
| TX | 330328102 | 05 | |
| TX | MEDICARE | 772093 | 01 |
| TX | BCBS BLUE | 8066NF | 01 |
| TX | TRICARE | 75-2616977-007 | 01 |
| TX | 330328101 | 05 |
| Street Address |
520 DOUGLAS BLVD |
| City | TYLER |
| State | TX |
| Zip Code | 75702-8307 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831197342 | Jean Rene Yates-halbert | Physician Assistant | 520 Douglas Blvd, Tyler, TX 75702-8307 | 2005-07-08 |
| 1316555220 | Sherry Mathew | Pharmacist | 520 Douglas Blvd, Tyler, TX 75702-8307 | 2020-07-16 |
| 1407487549 | Rosie M Niebuhr | Social Worker | 520 Douglas Blvd, Tyler, TX 75702-8307 | 2020-01-28 |
| 1366899288 | Jeta Laurie Bowman | Nurse Practitioner | 520 Douglas Blvd, Tyler, TX 75702 | 2016-05-20 |
| 1679944946 | Laura Beth Sheets | Nurse Practitioner | 520 Douglas Blvd, Tyler, TX 75702-8307 | 2015-10-13 |
| 1134596554 | Barakha Yadav Silvia | Pharmacist | 520 Douglas Blvd, Tyler, TX 75702-8307 | 2015-09-02 |
| 1184009565 | Alyssa Laurich | Pharmacist | 520 Douglas Blvd, Tyler, TX 75702-8307 | 2015-07-27 |
| 1285030981 | Kerri Martin | Nurse Practitioner | 520 Douglas Blvd, Tyler, TX 75702-8307 | 2014-11-07 |
| 1710395819 | Maria Diaz | Pharmacist | 520 Douglas Blvd, Tyler, TX 75702-8307 | 2014-08-01 |
| 1487072120 | Katie Storrs | Physician Assistant | 520 Douglas Blvd, Tyler, TX 75702-8307 | 2014-03-31 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679116610 | Tiffiney Mcmakin | Nurse Practitioner | 810 E Houston St # 100, Tyler, TX 75702 | 2019-10-22 |
| 1659852507 | Krystal Gayle Lilley | Licensed Vocational Nurse | 100 E Ferguson St Ste 60a, Tyler, TX 75702 | 2018-08-28 |
| 1679029383 | Cynthia Lynn Kalawe | Physical Therapist | 100 E Ferguson, Suite 1204, Tyler, TX 75702 | 2016-09-01 |
| 1649623646 | Susan E Oxford | Social Worker | 13495 Frankston Highway, Tyler, TX 75702 | 2016-07-14 |
| 1053769281 | All Kidz Kan | Home Health | 2902 E Front St, Tyler, TX 75702 | 2016-05-27 |
| 1821415639 | Heather Mullins | Physical Therapy Assistant | 100 E. Ferguson Ste.1204, Tyler, TX 75702 | 2014-03-19 |
| 1346671336 | Dennis Keith Johnson | Dentist | 3081 Hwy. 31 East, Tyler, TX 75702 | 2013-12-02 |
| 1275882201 | Bobby Gibson | Counselor | 401 East Front Street, Ste 233, Tyler, TX 75702 | 2012-09-06 |
| 1144596792 | Tina Marie Borke | Clinical Neuropsychologist | 719 West Front St., Tyler, TX 75702 | 2012-03-28 |
| 1457629529 | James Whaley Rapp | Specialist/Technologist | 430 South Beckham Avenue, Trinity Mother Frances Sports Medicine, Tyler, TX 75702 | 2011-12-05 |
| Find all providers in zip 75702 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841830601 | David Clay Mcintyre | Nurse Practitioner | 7924 S Broadway Ave Ste 900, Tyler, TX 75703-5252 | 2020-01-09 |
| 1750805941 | Roger Bryan Chapman | Nurse Practitioner | 6115 New Copeland Rd, Tyler, TX 75703 | 2017-07-28 |
| 1477925600 | Brenda Leath Goings | Nurse Practitioner | 703 S Fleishel Ave # 5000, Tyler, TX 75701 | 2015-10-27 |
| 1750708368 | Crossway Family Health Center Pllc | Nurse Practitioner | 6004 South Broadway, Tyler, TX 75703-4424 | 2014-03-20 |
| 1780952580 | Loretta Eve Wilson | Nurse Practitioner | 700 Olympic Plaza Cir Ste 904, Tyler, TX 75701-1958 | 2011-12-07 |
| 1558442376 | Christina Danielle Barnes | Nurse Practitioner | 800 E Dawson St - Hospitalists, Tyler, TX 75701 | 2006-10-18 |
| 1164406773 | Gayle Pegler Varnell | Nurse Practitioner | 3900 University Blvd, Tyler, TX 75799-0001 | 2005-12-06 |
| 1922080076 | Kerry Scruggs | Nurse Practitioner | 3310 Patriot Dr, Tyler, TX 75701-6606 | 2005-11-15 |
| 1003414525 | Abram Ambriz | Nurse Practitioner | 2608 Mcdonald Rd, Tyler, TX 75701-5934 | 2020-10-16 |
| 1396350039 | Lorna Casey Blakney | Nurse Practitioner | 1305 Doctors Dr, Tyler, TX 75701-2263 | 2020-09-10 |
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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.