Active NPI
Tommy Dean Wade, P.T.
- Physical Therapist
- Oklahoma City, OK
National Provider Identifier
1336262351
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1446
- Practice address
- 6400 N Santa Fe Ave
Ste. B
Oklahoma City, OK 73116-9126 - Phone
- (405) 840-2903
- Fax
- (405) 840-3256
- NPI assigned
- Apr 6, 2007
- Last updated
- Sep 21, 2007
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1446 | OK | Primary |
Addresses
Primary practice location
6400 N Santa Fe Ave
Ste. B
Oklahoma City, OK 73116-9126
Mailing address
4115 Michael Rd.
Edmond, OK 75025
Phone (405) 348-8515
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1446 | OK | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Focus on Function, Inc. | Physical Therapist | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Physical Therapist
- Edmond, OK
- NPI 1700950367
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175817600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1190332800000",
"number": "1336262351",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4115 MICHAEL RD.",
"city": "EDMOND",
"state": "OK",
"postal_code": "75025",
"telephone_number": "405-348-8515"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6400 N SANTA FE AVE",
"address_2": "STE. B",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731169126",
"telephone_number": "405-840-2903",
"fax_number": "405-840-3256"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WADE",
"first_name": "TOMMY",
"middle_name": "DEAN",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-06",
"last_updated": "2007-09-21",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OK",
"license": "1446",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oklahoma City, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.