Ellin Wade, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

L8-0000116 Issued in DE

Practice address

910 S Chapel St
Suite 102
Newark, DE 19713-3467

Phone

(302) 224-1400

Fax

(302) 224-1402

NPI assigned

Jul 31, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in DE, MA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lifestancehealth.ellinwade@139414.advancedmd-direct.com
• Direct secure messaging: lifestancehealth.ellinwade@147611.advancedmd-direct.com
• Direct secure messaging: lifestancehealth.ellinwade@148542.advancedmd-direct.com

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.

• Westside Family Healthcare, Inc.

  • Federally Qualified Health Center (FQHC)
  • Wilmington, DE
  • NPI 1952303695
  Medicare reassignment NPD
• Child and Family Psychological Services, PLLC

  • Psychologist
  • Norwood, MA
  • NPI 1912987181
  Medicare reassignment NPD

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

{
    "created_epoch": "1217462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366675200000",
    "number": "1417113309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 S CHAPEL ST",
            "address_2": "SUITE 102",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197133467",
            "telephone_number": "302-224-1400",
            "fax_number": "302-224-1402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 S CHAPEL ST",
            "address_2": "SUITE 102",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197133467",
            "telephone_number": "302-224-1400",
            "fax_number": "302-224-1402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADE",
        "first_name": "ELLIN",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-31",
        "last_updated": "2013-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TN",
            "license": "13502",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "DE",
            "license": "L8-0000116",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1519530",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Malia Voytik, MD
• Catherine A Vroome, MS, RD
• Myhanh Vu, DMD
• Vytalminds
• Jessica Ann Waatti, PA
• Samantha Wade
• Alexander Waggener
• Brianne Wagner
• Patricia Wagner
• Valerie Hammel Wagner

• Psychiatric/Mental Health Nurse Practitioner in Newark, DE
• Providers in Newark, DE by specialty
• Psychiatric/Mental Health Nurse Practitioner in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.