Individual provider Active NPI

Caitlin P Wade, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Alpena, MI
National Provider Identifier
1457081036
Registry record updated Apr 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
4704343227 Issued in MI
Practice address
400 Johnson St
Alpena, MI 49707-1434
Phone
(989) 356-2161
NPI assigned
Jun 15, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 4704343227 MI Primary

Addresses

Primary practice location

400 Johnson St
Alpena, MI 49707-1434

Mailing address

400 Johnson St
Alpena, MI 49707-1434
Phone (989) 356-2161

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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 1

Enrollment IDStateProvider typePAC IDDetails
I20220909002572 MI Practitioner - Nurse Practitioner 6608251731 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Northeast Michigan Community Mental Health AuthorityGroup PAC ID 2264498005, 14 clinicians

Practice addresses (Care Compare)

156 N 4TH St
Rogers City, MI 49779-1619
Phone (989) 734-7223

400 Johnson St
Alpena, MI 49707-1434
Phone (989) 356-2161

630 Caring St
Hillman, MI 49746-8818
Phone (989) 742-4549

Hospital & facility affiliations

  • Mymichigan Medical Center Alpena Hospital, Alpena, MI, CCN 230036

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Michigan Community Mental Health Authority CurrentSince Aug 29, 2022 Accepting new patients
Northeast Michigan Community Mental Health Authority PastSince Jun 21, 2022 Accepting new patients

Locations

400 Johnson St
Alpena, MI 49707
Phone (989) 354-2515

156 N 4th St
Rogers City, MI 49779
Phone (989) 734-7223

Organizations & group practices 2

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 3

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": "1655251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681689600000",
    "number": "1457081036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 JOHNSON ST",
            "city": "ALPENA",
            "state": "MI",
            "postal_code": "497071434",
            "telephone_number": "989-356-2161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 JOHNSON ST",
            "city": "ALPENA",
            "state": "MI",
            "postal_code": "497071434",
            "telephone_number": "989-356-2161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADE",
        "first_name": "CAITLIN",
        "middle_name": "P",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-15",
        "last_updated": "2023-04-17",
        "certification_date": "2023-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MI",
            "license": "4704343227",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alpena, MI

Sources for this page

Verify at the official NPI Registry.