Individual provider Active NPI

Deborah Wade, CNM

  • Advanced Practice Midwife
  • Elmira, NY
National Provider Identifier
1043384597
Registry record updated Aug 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
F000862-1 Issued in NY
Practice address
600 Fitch St
Suite 102
Elmira, NY 14905-1634
Phone
(607) 734-6544
Fax
(607) 734-6580
NPI assigned
Nov 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X F000862-1 NY Primary

Addresses

Primary practice location

600 Fitch St
Suite 102
Elmira, NY 14905-1634

Mailing address

571 Saint Josephs Blvd FL 2
Elmira, NY 14901-3230
Phone (607) 271-2050

Other identifiers 2

IdentifierTypeStateIssuer
02371451MedicaidNY
J400224142OtherNYMEDICARE PTAN

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)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
F000862-1NYMDAdvanced Practice Midwife

NPI Registry JSON

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472515200000",
    "number": "1043384597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "571 SAINT JOSEPHS BLVD FL 2",
            "city": "ELMIRA",
            "state": "NY",
            "postal_code": "149013230",
            "telephone_number": "607-271-2050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 FITCH ST",
            "address_2": "SUITE 102",
            "city": "ELMIRA",
            "state": "NY",
            "postal_code": "149051634",
            "telephone_number": "607-734-6544",
            "fax_number": "607-734-6580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADE",
        "first_name": "DEBORAH",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-17",
        "last_updated": "2016-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "NY",
            "license": "F000862-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02371451",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "J400224142",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmira, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2016; 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.