Individual provider Active NPI

Brian A Wade

  • Family Nurse Practitioner
  • Grants Pass, OR
National Provider Identifier
1114641370
Registry record updated Sep 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11015250 Issued in FL
Practice address
500 SW Ramsey Ave
Grants Pass, OR 97527-5554
Phone
(541) 472-7430
NPI assigned
Sep 30, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11015250 FL Primary

Addresses

Primary practice location

500 SW Ramsey Ave
Grants Pass, OR 97527-5554

Mailing address

3480 Exeter CT
Belle Isle, FL 32812-6029
Phone (407) 491-5254

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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

Enrollment IDStateProvider typePAC IDDetails
I20230303000327 OR Practitioner - Nurse Practitioner 1951774439 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
AsanteGroup PAC ID 0547177321, 141 clinicians
Asante Three Rivers Medical Center LLCGroup PAC ID 9931197993, 98 clinicians

Practice addresses (Care Compare)

2825 E Barnett Rd
Medford, OR 97504-8332
Phone (541) 789-7000

500 SW Ramsey Ave
Grants Pass, OR 97527-5554
Phone (541) 472-7000

Hospital & facility affiliations

  • Asante Three Rivers Medical Center Hospital, Grants Pass, OR, CCN 380002
  • Asante Rogue Regional Medical Center Hospital, Medford, OR, CCN 380018

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11015250FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Asante Three Rivers Medical Center, LLC CurrentSince Jan 30, 2023 Accepting new patients
Asante CurrentSince Jan 30, 2023 Accepting new patients
Asante CurrentSince Jan 30, 2023 Accepting new patients
Asante Ashland Community Hospital, LLC CurrentSince Jan 8, 2025 Accepting new patients
Oregon Behavioral Health Group LLC Past Accepting new patients

Locations

280 Maple St
Ashland, OR 97520
Phone (541) 201-4000

2825 E Barnett Rd
Medford, OR 97504
Phone (541) 282-6770

Organizations & group practices 5

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1664496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664496000000",
    "number": "1114641370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3480 EXETER CT",
            "city": "BELLE ISLE",
            "state": "FL",
            "postal_code": "328126029",
            "telephone_number": "407-491-5254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 SW RAMSEY AVE",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975275554",
            "telephone_number": "541-472-7430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADE",
        "first_name": "BRIAN",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-09-30",
        "last_updated": "2022-09-30",
        "certification_date": "2022-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11015250",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grants Pass, OR

Sources for this page

Verify at the official NPI Registry.