Tambaneka Wade, CN0028858650

Primary specialty

Nurse's AideTaxonomy code 376K00000X

License

CN0028858650 Issued in GA

Practice address

5959 Fairington Rd Apt 7C
Lithonia, GA 30038-1757

Phone

(404) 246-5307

NPI assigned

Oct 12, 2022

Last updated

Oct 12, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

State licenses

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

{
    "created_epoch": "1665532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665532800000",
    "number": "1174248108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5959 FAIRINGTON RD APT 7C",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300381757",
            "telephone_number": "404-246-5307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5959 FAIRINGTON RD APT 7C",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300381757",
            "telephone_number": "404-246-5307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADE",
        "first_name": "TAMBANEKA",
        "credential": "CN0028858650",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-12",
        "last_updated": "2022-10-12",
        "certification_date": "2022-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "GA",
            "license": "CN0028858650",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Village Podiatry Group LLC
• Visiting Labs, LLC
• Thomas Nicholas Vollmar, PT, DPT
• Quanghuy Vu, M.D.
• Latonya Wade-Crear, DDS
• Wal-Mart Stores East LP (WalMart Pharmacy 10-4472)
• Wal-Mart Stores East LP (Wal-Mart Vision Center 30-4472)
• Wal-Mart Stores East LP (Wal-Mart Pharmacy 10-1340)
• Wal-Mart Stores East, LP (Vision Center 30-1340)
• Theresa Hannah Walcot-Ceesay, RN

• Nurse's Aide in Lithonia, GA
• Providers in Lithonia, GA by specialty
• Nurse's Aide in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2022; 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.