Active NPI
Wade Kingery, MD
- Physical Medicine & Rehabilitation Physician
- Palo Alto, CA
National Provider Identifier
1043300742
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Medicine & Rehabilitation Physician
- License
- G56823
- Practice address
- 3801 Miranda Ave
Vapahcs, PMR (117)
Palo Alto, CA 94304-1207 - Phone
- (650) 493-5000
- NPI assigned
- Oct 13, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Medicine & Rehabilitation Physician | 208100000X | G56823 | CA | Primary |
Addresses
Primary practice location
3801 Miranda Ave
Vapahcs, PMR (117)
Palo Alto, CA 94304-1207
Mailing address
3801 Miranda Ave
Vapahcs, PMR (117)
Palo Alto, CA 94304-1207
Phone (650) 493-5000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 56823 | CA | MD | Pediatric Dentist |
| G56823 | CA | MD | Pain Medicine (Anesthesiology) Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160697600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1043300742",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3801 MIRANDA AVE",
"address_2": "VAPAHCS, PMR (117)",
"city": "PALO ALTO",
"state": "CA",
"postal_code": "943041207",
"telephone_number": "650-493-5000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3801 MIRANDA AVE",
"address_2": "VAPAHCS, PMR (117)",
"city": "PALO ALTO",
"state": "CA",
"postal_code": "943041207",
"telephone_number": "650-493-5000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KINGERY",
"first_name": "WADE",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208100000X",
"taxonomy_group": "",
"desc": "Physical Medicine & Rehabilitation",
"state": "CA",
"license": "G56823",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Palo Alto, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.