Nicholas Wade

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

109 W Watauga Ave
Johnson City, TN 37604-5621

Phone

(423) 232-2600

Fax

(423) 467-3644

NPI assigned

Oct 25, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1382659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1382659200000",
    "number": "1407284656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1167 SPRATLIN PARK DR",
            "city": "GRAY",
            "state": "TN",
            "postal_code": "376156205",
            "telephone_number": "423-467-3600",
            "fax_number": "423-469-3644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 W WATAUGA AVE",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376045621",
            "telephone_number": "423-232-2600",
            "fax_number": "423-467-3644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADE",
        "first_name": "NICHOLAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-10-25",
        "last_updated": "2013-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brooklyn Volkman, FNP-C
• Tiona Von Almen, COTA/L
• Shane D. Vore, PMHNP-BC
• Autum Wade
• John Joseph Wade
• Robin M Wade, DPT
• Julia Wagner
• Mariah M Wagner, PA-C
• Mary Elizabeth Wagner, M.S., CCC-SLP
• Vonda Karla Wagner, MA

• All providers in Johnson City, TN
• Case Manager/Care Coordinator in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2013; 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.