Active NPI
Anthony T. Wade, PA-C
- Physician Assistant
- Smyrna, GA
National Provider Identifier
1205944840
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 004101
- Practice address
- 3903 S Cobb Dr SE
Smyrna, GA 30080-6342 - Phone
- (678) 838-6600
- NPI assigned
- Aug 25, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 004101 | GA | Primary |
Addresses
Primary practice location
3903 S Cobb Dr SE
Smyrna, GA 30080-6342
Mailing address
2908 River Ridge HL
Decatur, GA 30034-6934
Phone (404) 819-9198
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
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ortho Sport & Spine Physicians | Past | Accepting new patients | |
| Peachtree Orthopaedic Clinic PA | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Surgery Physician
- Atlanta, GA
- NPI 1932525375
-
- Orthopaedic Surgery Physician
- Atlanta, GA
- NPI 1811912611
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156464000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1245801600000",
"number": "1205944840",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2908 RIVER RIDGE HL",
"city": "DECATUR",
"state": "GA",
"postal_code": "300346934",
"telephone_number": "404-819-9198"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3903 S COBB DR SE",
"city": "SMYRNA",
"state": "GA",
"postal_code": "300806342",
"telephone_number": "678-838-6600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WADE",
"first_name": "ANTHONY",
"middle_name": "T.",
"name_prefix": "Mr.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-25",
"last_updated": "2009-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "GA",
"license": "004101",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Smyrna, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.