Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Miss. Kelley Nicole Tate, PT

Individual provider Physical Therapist · NPI 1003811258

Miss. Kelley Nicole Tate, PT is a Physical Therapist in Private Practice in Boonville, Missouri. Graduated from University of Missouri, Columbia School of Medicine in 2002, 24 years ago. Practices with Empowerme Rehabilitation Missouri LLC, a 206-clinician group and accepts Medicare assignment. Licensed in Missouri.

Years since qualifying
24
Trained at
University of Missouri, Columbia School of Medicine
Licensed in
MO
In the registry since
2005
What do these letters mean?
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.

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Practice location Address checks out

1420 W Ashley Rd
Boonville, MO 65233-2112
Phone: (660) 882-6115
Fax: (660) 882-6120
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 2002025550 (MO)

Record details

NPI number1003811258
Entity typeIndividual (Type 1)
GenderFemale
Credentials PT
Sole proprietorNo
NPI enumeratedJune 15, 2005
Last updated in NPPESFebruary 20, 2025
Certification dateFebruary 20, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolUNIVERSITY OF MISSOURI, COLUMBIA SCHOOL OF MEDICINE
Graduated 2002 (24 years in practice)
Group practice Empowerme Rehabilitation Missouri Llc — 206 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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