Kelley Nicole Tate, P.T.
NPI 1003811258ActiveIndividual· Physical Therapist· Boonville, MO
Physical Therapist (P.T.) in Boonville, Missouri, trained at University of Missouri, Columbia School of Medicine (class of 2002). Enrolled in Medicare as practitioner - physical therapist in private practice.
Overview
| NPI | 1003811258 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | P.T. |
| Sole proprietor | No |
| NPI issued | Jun 15, 2005 |
| Last updated in NPPES | Feb 20, 2025 |
| Certified by provider | Feb 20, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 225100000X | 2002025550 | MO |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Physical Therapist in Private Practice (MO) |
|---|
Education and affiliations
| Medical school | University of Missouri, Columbia School of Medicine |
|---|---|
| Graduation year | 2002 |
| Medicare specialty | Physical Therapist In Private Practice |
Medical group
- Empowerme Rehabilitation Missouri LLCSaint Charles, MO · 216 clinicians
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