Glen Edward Tate (NPI# 1720082555, PAC ID# 1254525421) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
Nation Provider ID (NPI) | 1720082555 |
PAC ID by PECOS | 1254525421 |
Professional Enrollment ID | I20101101001532 |
Full Name | Glen Edward Tate |
Organization Legal Name | TRI AREA COMMUNITY HEALTH |
Address |
40 Wiley Dr Ferrum VA 24088-1100 |
Phone Number | 5403654469 |
Gender | M |
Medical School | UNIVERSITY OF VIRGINIA SCHOOL OF MEDICINE |
Graduation Year | 1981 |
Primary Specialty | FAMILY MEDICINE |
Group Practice PAC ID | 6204748296 |
Number of Group Practice Members | 17 |
Accepts Medicare Assignment | Y |
Claim Control Number (CCN) | Legal Business Name |
---|---|
490115 | TWIN COUNTY REGIONAL HOSPITAL |
340003 | NORTHERN HOSPITAL OF SURRY COUNTY |
490042 | CARILION NEW RIVER VALLEY MEDICAL CENTER |
Address | Phone | Organization |
---|---|---|
40 Wiley Dr, Ferrum, VA 24088-1100 | 5403654469 | TRI AREA COMMUNITY HEALTH |
140 Christiansburg Nepike, Floyd, VA 24091-3742 | 5407459290 | TRI AREA COMMUNITY HEALTH |
Organization Legal Name | TRI AREA COMMUNITY HEALTH |
Physicians | 14 |
Name | Specialty | Organization | Address |
---|---|---|---|
Anna W Wright | Psychologist, Clinical | Tri Area Community Health | 140 Christiansburg Nepike, Floyd, VA 24091-3742 |
Donna Gibson | Nurse Practitioner | Tri Area Community Health | 14558 Danville Pike, Suite 9, Laurel Fork, VA 24352-3982 |
April Crystal Hazelwood | Physician Assistant | Tri Area Community Health | 40 Wiley Dr, Ferrum, VA 24088-1100 |
Seyed H Saadat | Family Medicine | Tri Area Community Health | 140 Christiansburg Nepike, Floyd, VA 24091-3742 |
Dinah P Perdue | Nurse Practitioner | Tri Area Community Health | 14558 Danville Pike, Suite 9, Laurel Fork, VA 24352-3982 |
William R Bess Jr. | Emergency Medicine | Tri Area Community Health | 14558 Danville Pike, Suite 9, Laurel Fork, VA 24352-3982 |
Beverly A Forry | Physician Assistant | Tri Area Community Health | 40 Wiley Dr, Ferrum, VA 24088-1100 |
Amanda Elise Richardson | Physician Assistant | Tri Area Community Health | 140 Christiansburg Nepike, Floyd, VA 24091-3742 |
Gabriel Lee Edmondson | Family Medicine | Tri Area Community Health | 40 Wiley Dr, Ferrum, VA 24088-1100 |
Joshua M Bradley | Psychologist, Clinical | Tri Area Community Health | 14558 Danville Pike, Suite 9, Laurel Fork, VA 24352-3982 |
Street Address |
40 WILEY DR |
City | FERRUM |
State | VA |
Zip | 24088-1100 |
Name | Specialty | Organization | Address |
---|---|---|---|
April Crystal Hazelwood | Physician Assistant | Tri Area Community Health | 40 Wiley Dr, Ferrum, VA 24088-1100 |
Beverly A Forry | Physician Assistant | Tri Area Community Health | 40 Wiley Dr, Ferrum, VA 24088-1100 |
Gabriel Lee Edmondson | Family Medicine | Tri Area Community Health | 40 Wiley Dr, Ferrum, VA 24088-1100 |
Elizabeth A Hubbard | Nurse Practitioner | Tri Area Community Health | 40 Wiley Dr, Ferrum, VA 24088-1100 |
City | FERRUM |
Zip Code | 24088 |
Specialty | FAMILY MEDICINE |
City + Specialty | FERRUM + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Glen Edward Tate.
Data Provider | Centers for Medicare & Medicaid Services (CMS) |
Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.