Individual provider Active NPI

Christopher Andrew Wade

  • Massage Therapist
  • Southfield, MI
National Provider Identifier
1336650324
Registry record updated Oct 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
7501002226 Issued in MI
Practice address
25775 W 10 Mile Rd Ste C
Southfield, MI 48033-4856
Phone
(248) 809-9941
Fax
(248) 809-2480
NPI assigned
Oct 17, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 17, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225700000X 7501002226 MI Primary

Addresses

Primary practice location

25775 W 10 Mile Rd Ste C
Southfield, MI 48033-4856

Mailing address

25775 W 10 Mile Rd Ste C
Southfield, MI 48033-4856
Phone (248) 809-9941

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

LicenseStateTypeSpecialty
7501002226MIMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1508198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508198400000",
    "number": "1336650324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25775 W 10 MILE RD STE C",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480334856",
            "telephone_number": "248-809-9941",
            "fax_number": "248-809-2480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25775 W 10 MILE RD STE C",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480334856",
            "telephone_number": "248-809-9941",
            "fax_number": "248-809-2480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADE",
        "first_name": "CHRISTOPHER",
        "middle_name": "ANDREW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-10-17",
        "last_updated": "2017-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": "MI",
            "license": "7501002226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2017; 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.