Active NPI
Virginia K Wade, CSFA
- Surgical Assistant
- Montgomery, AL
National Provider Identifier
1114790730
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Assistant
- License
- 201844
- Practice address
- 1725 Pine St
Montgomery, AL 36106-1117 - Phone
- (334) 293-8700
- NPI assigned
- Nov 6, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Assistant | 246ZC0007X | 201844 | CO | Primary |
Addresses
Primary practice location
1725 Pine St
Montgomery, AL 36106-1117
Mailing address
1758 Park PL Ste 300
Montgomery, AL 36106-1137
Phone (334) 293-8922
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 201844 | CO | MD | Surgical Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1699228800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1699228800000",
"number": "1114790730",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1758 PARK PL STE 300",
"city": "MONTGOMERY",
"state": "AL",
"postal_code": "361061137",
"telephone_number": "334-293-8922",
"fax_number": "334-293-6820"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1725 PINE ST",
"city": "MONTGOMERY",
"state": "AL",
"postal_code": "361061117",
"telephone_number": "334-293-8700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WADE",
"first_name": "VIRGINIA",
"middle_name": "K",
"credential": "CSFA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-11-06",
"last_updated": "2023-11-06",
"certification_date": "2023-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "246ZC0007X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other, Surgical Assistant",
"state": "CO",
"license": "201844",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Montgomery, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.