NPIMap

Individual provider Active NPI

Jermaine Wade

  • Health Information Technician
  • Dallas, TX
National Provider Identifier
1003286733
Registry record updated Oct 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Information TechnicianTaxonomy code 247000000X
License
27-0660129 Issued in TX
Practice address
4100 Spring Valley Rd Ste 632
Dallas, TX 75244-3629
Phone
(972) 220-8619
NPI assigned
Oct 7, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Information Technician 247000000X 27-0660129 TX Primary

Addresses

Primary practice location

4100 Spring Valley Rd Ste 632
Dallas, TX 75244-3629

Mailing address

4100 Spring Valley Rd Ste 632
Dallas, TX 75244-3629
Phone (972) 220-8619

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Open MRI of Durant,LLC Current Accepting new patients
Zoom Diagnostic Imaging LLC Current Accepting new patients
Bluescrubs Diagnostics, LLC Technician, Health Information Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1444176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444176000000",
    "number": "1003286733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4100 SPRING VALLEY RD STE 632",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752443629",
            "telephone_number": "972-220-8619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 SPRING VALLEY RD STE 632",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752443629",
            "telephone_number": "972-220-8619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADE",
        "first_name": "JERMAINE",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-10-07",
        "last_updated": "2015-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "247000000X",
            "taxonomy_group": "",
            "desc": "Technician, Health Information",
            "state": "TX",
            "license": "27-0660129",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.