Dedra A. Wadsworth, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

TAP5036 Issued in AZ

Practice address

10240 N 31St Ave Ste 200
Phoenix, AZ 85051-9565

Phone

(602) 344-2500

Fax

(602) 247-9500

NPI assigned

Jun 17, 2013

Sex

Female

Sole proprietor

No

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

Enrolled in AZ

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

Specialty

Nurse Practitioner

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: dedra.wadsworth.p1@direct.lafrontera-empact.nextgenshare.com

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.

• Empact - Suicide Prevention Center

  dba Empact-SPC

  • Community/Behavioral Health Agency
  • San Tan Valley, AZ
  • NPI 1215311378
  NPD (past)
• Empact Suicide Prevention Center Inc

  • Community/Behavioral Health Agency
  • Glendale, AZ
  • NPI 1659414969
  NPD (past)
• Empact-Suicide Prevention Center

  • Community/Behavioral Health Agency
  • Tempe, AZ
  • NPI 1609071646
  NPD (past)

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

{
    "created_epoch": "1371427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371427200000",
    "number": "1205275997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2929 E THOMAS RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850168034",
            "telephone_number": "602-470-5043",
            "fax_number": "602-470-5064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10240 N 31ST AVE STE 200",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850519565",
            "telephone_number": "602-344-2500",
            "fax_number": "602-247-9500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADSWORTH",
        "first_name": "DEDRA",
        "middle_name": "A.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-17",
        "last_updated": "2013-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "TAP5036",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chelsea Wadiak
• Meleika A Wadley, LCSW
• Amy Christine Wadlington, LMSW
• Kandace Wadlington
• Katrina Wadowski, MD
• Zachary Mark Wadsworth, MD
• Jessica Waechter, CCC-SLP
• Bonny Wager Tabah, RD
• Mark Wager
• Kristi Wagers

• Family Nurse Practitioner in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.