Crystal Ann Wade, MSN, AG-ACNP-BC

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

11002837 Issued in FL

Practice address

12574 Flagler Center Blvd Ste 101
Jacksonville, FL 32258-2615

Phone

(904) 674-8037

Fax

(904) 582-1608

NPI assigned

Jun 19, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

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

Merit-based Incentive Payment System (MIPS)

Final score

59.59 of 100Reported as apm

Quality

59.93

Promoting interoperability

0

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

State licenses

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.

• University of Florida Jacksonville Physicians, Inc.

  • Internal Medicine Physician
  • Jacksonville, FL
  • NPI 1144276452
  Medicare reassignment NPD
• Wells Surgical Services, LLC

  • Surgery Physician
  • Jacksonville, FL
  • NPI 1174863872
  Medicare reassignment NPD
• Hypermobility Hub LLC

  • Nurse Practitioner
  • Jacksonville, FL
  • NPI 1588516777
  NPD
• University of Florida Jacksonville Physicians Inc

  • Orthopaedic Surgery Physician
  • Jacksonville, FL
  • NPI 1679733943
  NPD
• University of Florida Jacksonville Physicians, Inc.

  • Physiological Laboratory
  • Jacksonville, FL
  • NPI 1831800952
  NPD

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

{
    "created_epoch": "1560902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787875200000",
    "number": "1073173142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2285 MARSH HAWK LN APT 13102",
            "city": "FLEMING ISLAND",
            "state": "FL",
            "postal_code": "320033309",
            "telephone_number": "757-291-3876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12574 FLAGLER CENTER BLVD STE 101",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322582615",
            "telephone_number": "904-674-8037",
            "fax_number": "904-582-1608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADE",
        "first_name": "CRYSTAL",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "MSN, AG-ACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-19",
        "last_updated": "2026-08-28",
        "certification_date": "2026-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "11002837",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11002837",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "11002837",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "crystal.wade@1174865162993668.direct.elationemr.com",
            "affiliation": "Y",
            "endpointDescription": "Hypermobility Hub Secure Direct Messaging for Clinical Records, Referrals, and Care Coordination",
            "affiliationName": "Hypermobility Hub LLC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "12574 Flagler Center Blvd Ste 101",
            "city": "Jacksonville",
            "state": "FL",
            "country_code": "US",
            "postal_code": "322582615",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• John Kelly Wachira, MD
• Noah Zachary Wacker
• Racquel Denise Waddy
• Kadijo Wade-Thomas, MD
• Alicia Wade
• Erin Olivia Wade, PA-C
• Michelle Pinto Wade, PA-C
• Roger Dale Wade, RN
• Samantha Jayde Wade, MSW
• Sean Wade, M.D.

• Adult Health Nurse Practitioner in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Adult Health Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.