Healthcare Provider Details

I. General information

NPI: 1821903113
Provider Name (Legal Business Name): JAMES DALLAS PATE BCNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29000 CENTER RIDGE RD
WESTLAKE OH
44145-5219
US

IV. Provider business mailing address

4784 MILLS POINTE WAY UNIT 12
WESTLAKE OH
44145-5041
US

V. Phone/Fax

Practice location:
  • Phone: 440-827-2706
  • Fax:
Mailing address:
  • Phone: 210-267-7451
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAPRN.CNP.0042898
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: