Active NPI
Fabienne Marie Wade, PT
- Physical Therapist
- Honolulu, HI
National Provider Identifier
1184765281
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT 603
- Practice address
- 932 Ward Ave 6TH Floor Suite 600
Manakai O Malama
Honolulu, HI 96814 - Phone
- (808) 535-5555
- Fax
- (808) 535-5556
- NPI assigned
- Feb 9, 2007
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT 603 | HI | Primary |
Addresses
Primary practice location
932 Ward Ave 6TH Floor Suite 600
Manakai O Malama
Honolulu, HI 96814
Mailing address
59-791 Alapio Rd
Haleiwa, HI 96712-9514
Phone (808) 638-5087
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00H0028103 | Other | HI | HMSA |
| 025244 | Other | HI | ALOHA CARE |
| 142261 | Other | DEPT.OF LABOR WASH WC | |
| 142261 | Other | WA | DEPT.OF LABOR WASH. WC |
| 025244 | Other | ALOHA CARE | |
| 02524418 | Medicaid | HI |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT 603 | HI | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170979200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1295913600000",
"number": "1184765281",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "59-791 ALAPIO RD",
"city": "HALEIWA",
"state": "HI",
"postal_code": "967129514",
"telephone_number": "808-638-5087",
"fax_number": "808-535-5556"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "932 WARD AVE 6TH FLOOR SUITE 600",
"address_2": "MANAKAI O MALAMA",
"city": "HONOLULU",
"state": "HI",
"postal_code": "96814",
"telephone_number": "808-535-5555",
"fax_number": "808-535-5556"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WADE",
"first_name": "FABIENNE",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-09",
"last_updated": "2011-01-25",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "HI",
"license": "PT 603",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HMSA",
"identifier": "00H0028103",
"state": "HI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ALOHA CARE",
"identifier": "025244",
"state": "HI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEPT.OF LABOR WASH WC",
"identifier": "142261",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEPT.OF LABOR WASH. WC",
"identifier": "142261",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ALOHA CARE",
"identifier": "025244",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02524418",
"state": "HI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Honolulu, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.