Organization Active NPI

Abingdon Ear Nose & Throat Associates PC

  • Allergy Physician
  • Abingdon, VA
National Provider Identifier
1225145477
Registry record updated Aug 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy PhysicianTaxonomy code 207KA0200X
Legal business name
ABINGDON EAR NOSE & THROAT ASSOCIATES PC
Practice address
176 Valley St NW
Abingdon, VA 24210-2836
Phone
(276) 628-9547
Fax
(276) 628-8221
NPI assigned
Aug 24, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2008

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

Authorized official

Name
Dr. James M Wade, MD
Title
Physician
Phone
(276) 628-9547

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207KA0200X VA Primary

Addresses

Primary practice location

176 Valley St NW
Abingdon, VA 24210-2836

Mailing address

PO Box 1328
Abingdon, VA 24212-1328
Phone (276) 628-9547

Other identifiers 1

IdentifierTypeStateIssuer
067757OtherVABC/BS VA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, TN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20080624000610 VA Part B Supplier - Clinic/Group Practice 3971674656 Receives reassigned benefits from 2 practitioners
Practice locations: Abingdon, VA
O20190313002505 TN Part B Supplier - Clinic/Group Practice 3971674656 Receives reassigned benefits from 1 practitioner
Practice locations: Bristol, TN

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
49D1102059Abingdon Ear, Nose, and Throat Associates, PC176 Valley Street, Abingdon, VA 24210Certificate of waiverJul 8, 2027

National Provider Directory

National Provider Directory

Locations

176 Valley St NW
Abingdon, VA 24210
Phone (276) 628-9547

176 Valley St NW
Ste A
Abingdon, VA 24210

775 W Main St
Wytheville, VA 24382

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217980800000",
    "number": "1225145477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1328",
            "city": "ABINGDON",
            "state": "VA",
            "postal_code": "242121328",
            "telephone_number": "276-628-9547",
            "fax_number": "276-628-8221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "176 VALLEY ST NW",
            "city": "ABINGDON",
            "state": "VA",
            "postal_code": "242102836",
            "telephone_number": "276-628-9547",
            "fax_number": "276-628-8221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABINGDON EAR NOSE & THROAT ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-24",
        "last_updated": "2008-08-06",
        "status": "A",
        "authorized_official_last_name": "WADE",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "276-628-9547",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207KA0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Allergy & Immunology, Allergy",
            "state": "VA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS VA",
            "identifier": "067757",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Abingdon, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.