J Keith Wade, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

729OD Issued in WV

Practice address

405 Locust Ave
Fairmont, WV 26554-4717

Phone

(304) 366-2020

Fax

(304) 367-0863

NPI assigned

Mar 20, 2007

Last updated

Apr 22, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WV

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Myeyedr Optometry of West Virginia, PLLC

  dba MyEyeDr.

  • Optometrist
  • Martinsburg, WV
  • NPI 1053760363
  Medicare reassignment NPD
• Laughlin and Wade, Optometrists

  • Optometrist
  • Fairmont, WV
  • NPI 1477753838
  Authorized official Same address or phone
• Myeyedr Optometry of West Virginia, PLLC

  dba MyEyeDr.

  • Optometrist
  • Bridgeport, WV
  • NPI 1376105239
  NPD
• Myeyedr Optometry of West Virginia, PLLC

  dba MyEyeDr.

  • Optometrist
  • Martinsburg, WV
  • NPI 1700235017
  NPD

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208822400000",
    "number": "1295850410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 LOCUST AVE",
            "city": "FAIRMONT",
            "state": "WV",
            "postal_code": "265544717",
            "telephone_number": "304-366-2020",
            "fax_number": "304-367-0863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 LOCUST AVE",
            "city": "FAIRMONT",
            "state": "WV",
            "postal_code": "265544717",
            "telephone_number": "304-366-2020",
            "fax_number": "304-367-0863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADE",
        "first_name": "J",
        "middle_name": "KEITH",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-20",
        "last_updated": "2008-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WV",
            "license": "729OD",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0150700000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vision Health Care, Inc.
• Nicole Volek
• Maximillian Von Doemming
• Karen Sue Waddell
• Kristine Frances-Marie Waddell
• Gena D Wagaman
• William Wagoner, FNP
• Angel Waites
• Gregory Waites, MSW
• Michelle Wakeley, LCSW

• Optometrist in Fairmont, WV
• Providers in Fairmont, WV by specialty
• Optometrist in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2008; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.