Shaleise Andrea Wade, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

330952 Issued in NY

Practice address

911 Spur Dr N
Bay Shore, NY 11706-3354

Phone

(631) 459-0209

NPI assigned

Mar 5, 2018

Last updated

Mar 5, 2018By 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": "1520208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520208000000",
    "number": "1194227371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "911 SPUR DR N",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117063354",
            "telephone_number": "631-459-0209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 SPUR DR N",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117063354",
            "telephone_number": "631-459-0209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADE",
        "first_name": "SHALEISE",
        "middle_name": "ANDREA",
        "name_prefix": "Ms.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-05",
        "last_updated": "2018-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "330952",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kiran Vohra, MD
• Christine Baribeau Volavka, P.T.
• Dorothy Anne Vollmer
• Kelly Vollmer, LMHC
• Monica Maria Votra, NP
• Gabriel Michael Wagman, M.D.
• Aliesha Wahab, PHARMD
• Rachel Eve Waldman, PSYD
• Walgreen Co (Rite Aid)
• Mohamed Wali, MD

• Licensed Practical Nurse in Bay Shore, NY
• Providers in Bay Shore, NY by specialty
• Licensed Practical Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2018; 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.