Active NPI
Julie Wade
- Speech-Language Pathologist
- Derby, NY
National Provider Identifier
1386143295
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 027186
- Practice address
- 7821 Erie Rd
Derby, NY 14047-9502 - Phone
- (724) 674-2873
- NPI assigned
- Feb 6, 2018
- Last updated
- Feb 6, 2018
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 027186 | NY | Primary |
Addresses
Primary practice location
7821 Erie Rd
Derby, NY 14047-9502
Mailing address
896 Lake St
Angola, NY 14006-9281
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 027186 | Medicaid | NY |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1517875200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1517875200000",
"number": "1386143295",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "896 LAKE ST",
"city": "ANGOLA",
"state": "NY",
"postal_code": "140069281"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7821 ERIE RD",
"city": "DERBY",
"state": "NY",
"postal_code": "140479502",
"telephone_number": "724-674-2873"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WADE",
"first_name": "JULIE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-02-06",
"last_updated": "2018-02-06",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NY",
"license": "027186",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "027186",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Derby, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.