Heather Michelle Wade, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

ARNP9206589 Issued in FL

Practice address

421 Kingsley Ave Ste 300
Orange Park, FL 32073-4898

Phone

(904) 621-0643

Fax

(904) 621-0644

NPI assigned

Jul 16, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Heather Michelle Edwards Former name

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• PCP Financial Services LLC

  • Exclusive Provider Organization
  • Orange Park, FL
  • NPI 1134378078
  Medicare reassignment NPD
• Take Care Health Services PA

  • Family Nurse Practitioner
  • Orlando, FL
  • NPI 1689865818
  NPD (past)

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

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661299200000",
    "number": "1033136072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 WELLS RD STE 300",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320732982",
            "telephone_number": "904-282-6331",
            "fax_number": "904-619-1080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 KINGSLEY AVE STE 300",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734898",
            "telephone_number": "904-621-0643",
            "fax_number": "904-621-0644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADE",
        "first_name": "HEATHER",
        "middle_name": "MICHELLE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-16",
        "last_updated": "2022-08-24",
        "certification_date": "2022-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9206589",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "305910300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEATHER",
            "last_name": "EDWARDS",
            "middle_name": "MICHELLE",
            "credential": "A.R.N.P.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tina M Voisin, ARNP
• Timothy Lynn Vola, D.M.D.
• Albert Matthew Volk, MD
• Vonostir Innovation Services, L.L.C.
• Felisha Wade, PHARMD
• Samantha Nicole Wagner
• Cheryl Wakefield, PTA
• Michael Joshua Wakely, MD
• Elias Wakim, MD
• Wal-Mart Stores East LP

• Family Nurse Practitioner in Orange Park, FL
• Providers in Orange Park, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.