DR. SUSAN S.B. TATE (NPI# 1811913585) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811913585 |
| Entity Type | Individual |
| Full Name | DR. SUSAN S.B. TATE |
| Credential | M.D. |
| Practice Address |
2934 Breckenridge Ln Ste 2 Louisville KY 40220-3903 |
| Practice Telephone | 5024547871 |
| Practice Fax Number | 5024547872 |
| Mailing Telephone | 5024547871 |
| Mailing Fax Number | 5024547872 |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2014-09-29 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207VF0040X |
Obstetrics & Gynecology Specialization: Female Pelvic Medicine and Reconstructive Surgery |
39021 | KY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 200502730 | 05 | |
| KY | PASSPORT PCP | 50004926 | 01 |
| KY | PASSPORT SPECIALITY | 50015262 | 01 |
| KS | ANTHEM | 000000337344 | 01 |
| KY | PASSPORT SPECIALITY | 50004854 | 01 |
| KY | ANTHEM | 000000338030 | 01 |
| KY | 64084148 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457675563 | Susan R Tate | Physical Therapist | 3006 Mcneil Ave, Wichita Falls, TX 76309-4954 | 2010-03-18 |
| 1184611519 | Susan J Tate | Emergency Medicine | 4076 Neely Road, Fort Wainwright, AK 99703 | 2005-09-30 |
| 1558610501 | Susan Tate | Counselor | 1322 W Main St, Antlers, OK 74523-2016 | 2012-09-06 |
| 1184705261 | Susan Ray Tate | Psychologist | 3350 La Jolla Village Dr # 116b, San Diego, CA 92161-0002 | 2006-10-17 |
| 1053320259 | Susan Tate | Physician Assistant | 3401 Springhill Dr, Suite 460, North Little Rock, AR 72117-2924 | 2006-08-05 |
| Street Address |
2934 BRECKENRIDGE LN STE 2 |
| City | LOUISVILLE |
| State | KY |
| Zip Code | 40220-3903 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740227255 | Michael Alt | Psychiatry & Neurology | 2934 Breckenridge Ln Ste 2, Louisville, KY 40220-3903 | 2006-06-01 |
| 1437531837 | Susan B Tate Md Psc | Obstetrics & Gynecology | 2934 Breckenridge Ln Ste 2, Louisville, KY 40220-3903 | 2015-06-22 |
| 1508030032 | Michael Alt Do Psc | Psychiatry & Neurology | 2934 Breckenridge Ln Ste 2, Louisville, KY 40220-3903 | 2008-04-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811502560 | Louis James Walker IIi | Physical Therapist | 8904 Elks Bluff Drive, Unit 02206, Apt 206, Louisville, KY 40220 | 2020-09-10 |
| 1396207148 | Kristan Shay Swindler | Specialist/Technologist, Other | 3008 Furman Blvd., Louisville, KY 40220 | 2019-04-02 |
| 1033686191 | Reine Medical Supply LLC | Durable Medical Equipment & Medical Supplies | 3405 Breckenridge Lane, Louisville, KY 40220 | 2018-10-26 |
| 1053828145 | Angelique Marie Leist | Registered Nurse | 3103 Breckenridge Ln Ste 1, Louisville, KY 40220 | 2018-01-10 |
| 1811413925 | Virginia Zimlich | Physical Therapist | 2807 Alice Ave, Louisville, KY 40220 | 2017-08-21 |
| 1255860649 | Susan Marie Elder | Registered Nurse | 2816 Esther Blvd, Louisville, KY 40220 | 2017-06-08 |
| 1215300611 | Katie Kipfer | Day Training/Habilitation Specialist | 3902 Graf Drive, Louisville, KY 40220 | 2015-11-06 |
| 1639547987 | Meghan Hillerich | Home Health | 13 Canterbury Drive, Louisville, KY 40220 | 2015-09-03 |
| 1376921098 | Dental Services of Kentucky, Psc | Dentist | 3946 Taylorsville Rd., Louisville, KY 40220 | 2015-05-14 |
| 1093103574 | Joann Bartolone Murphy | Developmental Therapist | 3717 Taylorsville Rd., Louisville, KY 40220 | 2015-01-06 |
| Find all providers in zip 40220 | ||||
| Taxonomy Code | 207VF0040X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| Specialization | Female Pelvic Medicine and Reconstructive Surgery |
| A subspecialist in Female Pelvic Medicine and Reconstructive Surgery is a physician in Urology or Obstetrics and Gynecology who, by virtue of education and training, is prepared to provide consultation and comprehensive management of women with complex benign pelvic conditions, lower urinary tract disorders, and pelvic floor dysfunction. Comprehensive management includes those diagnostic and therapeutic procedures necessary for the total care of the patient with these conditions and complications resulting from them. |
| Notes: Source: American Board of Medical Specialties, 2011. [1/1/2012: new] Resources: www.abms.org |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205252426 | Susan B Tate Md Pa | Obstetrics & Gynecology | 2934 Breckenridge Ln, Suite 2, Louisville, KY 40220-3903 | 2014-03-12 |
| 1427470525 | University of Louisville Research Foundation Inc | Obstetrics & Gynecology | 401 E Chestnut St, Suite 410, Louisville, KY 40202-5700 | 2014-01-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174839401 | Gerardo Manuel Heredia Melero | Obstetrics & Gynecology | Uk Obgyn, 125 E. Maxwell Street, Lexington, KY 40508 | 2010-08-24 |
| 1003182270 | Caroline Elmer-lyon | Obstetrics & Gynecology | 610 Medical Village Dr, Edgewood, KY 41017-3416 | 2012-03-31 |
| 1336300300 | Sonali Vora Raman | Obstetrics & Gynecology | 1400 Grand Ave, Newport, KY 41071-2570 | 2008-06-22 |
| City | LOUISVILLE |
| Zip Code | 40220 |
Please comment or provide details below to improve the information on DR. SUSAN S.B. 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.