Keshia Demyra Wade

Primary specialty

Social WorkerTaxonomy code 104100000X

Practice address

8295 Tournament Dr
150
Memphis, TN 38125-8906

Phone

(866) 563-7772

Fax

(901) 969-4401

NPI assigned

Sep 6, 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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1378425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378425600000",
    "number": "1235564451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8295 TOURNAMENT DR",
            "address_2": "150",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381258906",
            "telephone_number": "866-563-7772",
            "fax_number": "901-969-4401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8295 TOURNAMENT DR",
            "address_2": "150",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381258906",
            "telephone_number": "866-563-7772",
            "fax_number": "901-969-4401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADE",
        "first_name": "KESHIA",
        "middle_name": "DEMYRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-06",
        "last_updated": "2013-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deanie Eilee Wade-Smith, APN, NP-C
• Hailey McKinney Wade
• Jennifer Jo Wade, D.D.S
• Jessica Wade, APRN
• Kelly Baker Wade, CRNA
• Lacy Wade
• Nathan Tucker Wade
• Tasha Wade
• Imelda Wafula, OT
• Allison Waggoner

• Social Worker in Memphis, TN
• Providers in Memphis, TN by specialty
• Social Worker in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 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.