Nicole Wade, PM

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Practice address

7800 W Outer Dr Ste 300
Detroit, MI 48235-3458

Phone

(313) 340-4442

NPI assigned

Sep 18, 2014

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1410998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563408000000",
    "number": "1083016281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6461 GREENVIEW AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482284765",
            "telephone_number": "313-214-7401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7800 W OUTER DR STE 300",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482353458",
            "telephone_number": "313-340-4442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADE",
        "first_name": "NICOLE",
        "name_prefix": "Miss",
        "credential": "PM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-18",
        "last_updated": "2019-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carol Wade, LPC
• Jasmine Diamond Wade, MA, LLPC
• Mary Wade
• Megan Wade
• Nanette M. Wade, LMSW
• Tanya Wade, LLMSW
• Vashti Lavonne Wade, NURSE
• Lorraine Wadlington
• Shazia Wadood, MD
• Camaria Shai Wafer, FULL SPECTRUM DOULA

• Community Health Worker in Detroit, MI
• Providers in Detroit, MI by specialty
• Community Health Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2019; 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.