Tracy C Wade, ARNP
Individual provider Active NPI Nurse Practitioner · Heflin, AL
NPI 1063458586 · NPPES record last updated May 7, 2009
Key facts
- NPI
- 1063458586
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 1-074382NP (AL)
- Practice address
- 242 Brockford Rd
Heflin, AL 36264-1608 - Phone
- (256) 463-2021
- Fax
- (256) 463-2024
- NPI assigned
- Jun 22, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 7
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Cheaha Area Regional Emergency Specialists
Practice addresses (Care Compare)
256 Oxford Exchange Blvd
Oxford, AL 36203-3453
Phone (256) 835-0076
Hospital & facility affiliations
- Northeast Alabama Regional Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050823000233 | AL | Practitioner - Nurse Practitioner | 8820029523 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1-074382NP | AL | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cheaha Area Regional Emergency Specialists | Current |
Accepting new patients | |
| Quality of Life Health Services, Inc | Current | Accepting new patients | |
| Quality of Life Health Services, Inc | Current |
Accepting new patients | |
| Quality of Life Health Services, Inc | Current |
Accepting new patients | |
| Quality of Life Health Services Inc | Current | Accepting new patients | |
| Quality of Life Health Services, Inc | Past | Accepting new patients | |
| Cheaha Area Regional Emergency Services of Oxford | Past |
Accepting new patients |
Locations
400 E 10th St
Anniston, AL 36207
Phone (256) 235-5121
1325 Quintard Ave
Anniston, AL 36201
Phone (256) 741-1339
1411 Piedmont Cutoff
Gadsden, AL 35903
Phone (205) 492-0131
242 Brockford Rd
Heflin, AL 36264
Phone (256) 463-2021
256 Oxford Exchange Blvd
Oxford, AL 36203
Phone (256) 835-0076
Interoperability endpoints
- twade333089@direct.ochin.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 1-074382NP | AL | Yes |
Addresses
Primary practice location
242 Brockford Rd
Heflin, AL 36264-1608
Mailing address
1411 Piedmont Cutoff
Gadsden, AL 35903-2708
Phone (256) 492-0131
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 891010520 | Medicaid | AL | |
| 108870 | Medicaid | AL |
Other providers in Heflin, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 7, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.