NPIMap

Individual provider Active NPI

James P Wade, MD

  • Family Medicine Physician
  • Belleville, IL
National Provider Identifier
1386640399
Registry record updated Sep 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036095025 Issued in IL
Practice address
311 W Lincoln St Ste 200
Belleville, IL 62220-1902
Phone
(618) 213-7943
Fax
(618) 213-2137
NPI assigned
Jun 23, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036095025 IL Primary

Addresses

Primary practice location

311 W Lincoln St Ste 200
Belleville, IL 62220-1902

Mailing address

311 W Lincoln St Ste 200
Belleville, IL 62220-1902
Phone (618) 213-7943

Other identifiers 1

IdentifierTypeStateIssuer
1386640399MedicaidIL

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address james.wade.1@9559.direct.athenahealth.com Direct
Direct Messaging Address james.wade.1@9559.direct.athenahealth.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040217000718 IL Practitioner - Family PracticePractitioner - Internal MedicinePractitioner - Emergency Medicine 2163317363 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Emergency Medicine
Education
Southern Illinois University School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

180 S 3Rd St
Suite 104
Belleville, IL 62220-1952
Phone (618) 233-5480

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Illinois Healthcare Foundation Inc Family Medicine Current Accepting new patients
Southern Illinois Healthcare Foundation, Inc Family Medicine CurrentSince Dec 19, 2022 Accepting new patients
Southern Illinois Healthcare Foundation Inc CurrentSince Dec 19, 2022 Accepting new patients
PC Associates, LLC Family Medicine Past Accepting new patients
Healthcare Physicians of Southern Illinois, PC Family Medicine Past Accepting new patients
Fairview Heights Medical Group SC Past Accepting new patients

Locations

180 S 3rd St
Ste 104
Belleville, IL 62220
Phone (618) 222-4701

311 W Lincoln St
Ste 200
Belleville, IL 62220
Phone (618) 213-7943

180 S 3rd St
Ste 103
Belleville, IL 62220
Phone (618) 213-7921

6000 Bond Ave
East Saint Louis, IL 62207
Phone (618) 332-2740

2001 State St
East St Louis, IL 62205
Phone (618) 271-0204

Interoperability endpoints

  • Direct secure messaging: james.wade.1@9559.direct.athenahealth.com

Organizations & group practices 6

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

Hospital & facility affiliations 11

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1119484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726704000000",
    "number": "1386640399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 W LINCOLN ST STE 200",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622201902",
            "telephone_number": "618-213-7943",
            "fax_number": "618-213-2137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 W LINCOLN ST STE 200",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622201902",
            "telephone_number": "618-213-7943",
            "fax_number": "618-213-2137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADE",
        "first_name": "JAMES",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-23",
        "last_updated": "2024-09-19",
        "certification_date": "2024-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036095025",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1386640399",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "james.wade.1@9559.direct.athenahealth.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "180 S 3rd St Ste 103",
            "city": "Belleville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "622201952",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "james.wade.1@9559.direct.athenahealth.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "311 W Lincoln St Ste 200",
            "city": "Belleville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "622201902",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Belleville, IL

Sources for this page

Verify at the official NPI Registry.