Active NPI
Stephanie G Wade, MPH, RD
- Registered Dietitian
- Miramar, FL
National Provider Identifier
1285865147
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- ND 4558
- Practice address
- 3114 Commerce Parkway
Miramar, FL 33025-3943 - Phone
- (305) 816-5800
- Fax
- (305) 816-5844
- NPI assigned
- Jul 27, 2009
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | ND 4558 | FL | Primary |
Addresses
Primary practice location
3114 Commerce Parkway
Miramar, FL 33025-3943
Mailing address
3114 Commerce Parkway
Miramar, FL 33025-3943
Phone (305) 816-5800
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ND 4558 | FL | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wellness 4 Life Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Nutritionist
- Pembroke Pines, FL
- NPI 1033357009
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1248652800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1248652800000",
"number": "1285865147",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3114 COMMERCE PARKWAY",
"city": "MIRAMAR",
"state": "FL",
"postal_code": "330253943",
"telephone_number": "305-816-5800",
"fax_number": "305-816-5844"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3114 COMMERCE PARKWAY",
"city": "MIRAMAR",
"state": "FL",
"postal_code": "330253943",
"telephone_number": "305-816-5800",
"fax_number": "305-816-5844"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WADE",
"first_name": "STEPHANIE",
"middle_name": "G",
"name_prefix": "Miss",
"credential": "MPH, RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-07-27",
"last_updated": "2009-07-27",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "FL",
"license": "ND 4558",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Miramar, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 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.