Healthcare Provider Details

I. General information

NPI: 1225651003
Provider Name (Legal Business Name): JOHN PATE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2020
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

983280 NEBRASKA MEDICAL CTR
OMAHA NE
68198-3280
US

IV. Provider business mailing address

983280 NEBRASKA MEDICAL CTR
OMAHA NE
68198-3280
US

V. Phone/Fax

Practice location:
  • Phone: 402-559-4017
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License Number10702
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: