Active NPI
Brandon Wade
- Physical Therapy Assistant
- Mooresville, NC
National Provider Identifier
1346908456
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- A7727
- Practice address
- 136 Corporate Park Dr
Mooresville, NC 28117-6959 - Phone
- (704) 360-2796
- NPI assigned
- Dec 6, 2021
- 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 Therapy Assistant | 225200000X | A7727 | NC | Primary |
Addresses
Primary practice location
136 Corporate Park Dr
Mooresville, NC 28117-6959
Mailing address
3009 Bermuda Bay LN Apt 104
Mebane, NC 27302-9870
Phone (919) 951-8987
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 |
|---|---|---|---|
| A7727 | NC | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1638748800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1638748800000",
"number": "1346908456",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3009 BERMUDA BAY LN APT 104",
"city": "MEBANE",
"state": "NC",
"postal_code": "273029870",
"telephone_number": "919-951-8987"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "136 CORPORATE PARK DR",
"city": "MOORESVILLE",
"state": "NC",
"postal_code": "281176959",
"telephone_number": "704-360-2796"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WADE",
"first_name": "BRANDON",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-12-06",
"last_updated": "2021-12-06",
"certification_date": "2021-12-06",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "NC",
"license": "A7727",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mooresville, NC
- Frederick U Vorwald, MD
- Amanda E Vought, MED CCC SLP
- Vyve Wellness Lake Norman
- W Jason Metzger
- Amber W Waddell, FNP-C
- Wal-Mart Stores East LP (Walmart Pharmacy 10-4431)
- Wal-Mart Stores East LP (Walmart Pharmacy 10-1156)
- Wal-Mart Stores East, LP. (Walmart pharmacy 10-3164)
- Bartosz Adam Walczyszyn, M.D.
- Kristy L Waldeck, MSPT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.