Individual provider Active NPI

Debbie Ann Wade, FNP

  • Family Nurse Practitioner
  • Paragould, AR
National Provider Identifier
1174560965
Registry record updated Mar 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
A01264 Issued in AR
Practice address
900 W Kingshighway
Paragould, AR 72450-5942
Phone
(870) 239-7138
NPI assigned
Jun 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 2005005588 MO
Family Nurse Practitioner 363LF0000X A01264 AR Primary

Addresses

Primary practice location

900 W Kingshighway
Paragould, AR 72450-5942

Mailing address

900 W Kingshighway
Paragould, AR 72450-5942
Phone (870) 239-7138

Other identifiers 1

IdentifierTypeStateIssuer
427436605MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20110524000881 AR Practitioner - Nurse Practitioner 9830129717 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
91.6 of 100Reported as group
Quality
82.11
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
East Arkansas Emergency Physicians, PLLC Nurse Practitioner Current Accepting new patients
East Arkansas Emergency Physicians, PLLC Nurse Practitioner CurrentSince Sep 1, 2015 Accepting new patients
East Arkansas Emergency Physicians, PLLC Nurse Practitioner CurrentSince Sep 1, 2015 Accepting new patients
Acs Primary Care Physicians of Arkansas PA Past Accepting new patients
TH Contracting Services of Missouri Past Accepting new patients
Doctors Inn Clinic LLC PastSince Dec 1, 2009 Accepting new patients

Locations

1520 N Division St
Blytheville, AR 72315
Phone (870) 838-7300

900 W Kingshighway
Paragould, AR 72450
Phone (870) 239-7000

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584057600000",
    "number": "1174560965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 W KINGSHIGHWAY",
            "city": "PARAGOULD",
            "state": "AR",
            "postal_code": "724505942",
            "telephone_number": "870-239-7138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 W KINGSHIGHWAY",
            "city": "PARAGOULD",
            "state": "AR",
            "postal_code": "724505942",
            "telephone_number": "870-239-7138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADE",
        "first_name": "DEBBIE",
        "middle_name": "ANN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-01",
        "last_updated": "2020-03-13",
        "certification_date": "2020-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "2005005588",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "A01264",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "427436605",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Paragould, AR

Sources for this page

Verify at the official NPI Registry.