Provider Demographics
NPI:1376765032
Name:BATE, KERRY (OTR, CHT)
Entity Type:Individual
Prefix:
First Name:KERRY
Middle Name:
Last Name:BATE
Suffix:
Gender:F
Credentials:OTR, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:732 THIMBLE SHOALS BLVD STE 905
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-4218
Mailing Address - Country:US
Mailing Address - Phone:757-232-8769
Mailing Address - Fax:757-916-5805
Practice Address - Street 1:732 THIMBLE SHOALS BLVD STE 905
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-4218
Practice Address - Country:US
Practice Address - Phone:757-916-5800
Practice Address - Fax:757-916-5805
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2021-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008751-1174400000X
VA0119008254225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA400026953Medicare PIN