Organization Active NPI

Sandra M. Wade, FNP Inc.

  • Family Nurse Practitioner
  • Harriman, TN
National Provider Identifier
1184834541
Registry record updated Feb 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APN000005322 Issued in TN
Legal business name
SANDRA M. WADE, FNP INC.
Practice address
2415 N Gateway Ave
Harriman, TN 37748-8609
Phone
(865) 882-2002
Fax
(865) 590-0475
NPI assigned
May 23, 2007
Last updated
Feb 4, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2013

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

Authorized official

Name
Sandra M Wade, FNP
Title
Practitioner
Phone
(865) 882-2002

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APN000005322 TN Primary

Addresses

Primary practice location

2415 N Gateway Ave
Harriman, TN 37748-8609

Mailing address

2415 N Gateway Ave
Harriman, TN 37748-8609
Phone (865) 882-2002

Other identifiers 1

IdentifierTypeStateIssuer
1811966484OtherTNSANDRA WADE NPI #

National Provider Directory

National Provider Directory

Locations

900 Waterford Pl
Ste 100
Kingston, TN 37763
Phone (865) 717-1121

728 Emory Valley Rd
Oak Ridge, TN 37830

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1359936000000",
    "number": "1184834541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2415 N GATEWAY AVE",
            "city": "HARRIMAN",
            "state": "TN",
            "postal_code": "377488609",
            "telephone_number": "865-882-2002",
            "fax_number": "865-590-0475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2415 N GATEWAY AVE",
            "city": "HARRIMAN",
            "state": "TN",
            "postal_code": "377488609",
            "telephone_number": "865-882-2002",
            "fax_number": "865-590-0475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANDRA M. WADE, FNP INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-23",
        "last_updated": "2013-02-04",
        "status": "A",
        "authorized_official_last_name": "WADE",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRACTITIONER",
        "authorized_official_telephone_number": "865-882-2002",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "APN000005322",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SANDRA WADE NPI #",
            "identifier": "1811966484",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Harriman, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2013; 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.