Virgie C Wade, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R119030 Issued in MS

Practice address

130 North High St
Shubuta, MS 39360

Phone

(601) 687-1391

Fax

(601) 687-0051

NPI assigned

Mar 21, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Anderson Physician Alliance, Inc.

  • Multi-Specialty Clinic/Center
  • Meridian, MS
  • NPI 1760798227
  NPD (past)
• Meridian Hma Clinic Management LLC

  • Family Medicine Physician
  • Meridian, MS
  • NPI 1902969850

  Family

  NPD (past)
• Outreach Health Services,Inc.

  • Health Maintenance Organization
  • Heidelberg, MS
  • NPI 1255521480
  NPD (past)
• Outreach Health Services,Inc.

  • Community Health Clinic/Center
  • Shubuta, MS
  • NPI 1548359565
  NPD (past)

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1457477481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 COUNTY ROAD 275",
            "city": "VOSSBURG",
            "state": "MS",
            "postal_code": "393669475",
            "telephone_number": "601-776-2052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 NORTH HIGH ST",
            "city": "SHUBUTA",
            "state": "MS",
            "postal_code": "39360",
            "telephone_number": "601-687-1391",
            "fax_number": "601-687-0051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADE",
        "first_name": "VIRGIE",
        "middle_name": "C",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R119030",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "011312",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Superior Home Care
• Superior Home Care
• Takila Terrell
• The Magnolia Center
• Tiermax Homecare Services

• All providers in Shubuta, MS
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.