Active NPI
Grace Wade, PHARMD
- Pharmacist
- Dodge City, KS
National Provider Identifier
1467064204
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 1-103349
- Practice address
- 1801 N 14TH Ave
Dodge City, KS 67801-2302 - Phone
- (620) 225-6095
- Fax
- (620) 225-6578
- NPI assigned
- Aug 22, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 1-103349 | KS | Primary |
Addresses
Primary practice location
1801 N 14TH Ave
Dodge City, KS 67801-2302
Mailing address
1801 N 14TH Ave
Dodge City, KS 67801-2302
Phone (620) 225-6095
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | rxm.07817@store.walgreens.com | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1-103349 | KS | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1598054400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1598054400000",
"number": "1467064204",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1801 N 14TH AVE",
"city": "DODGE CITY",
"state": "KS",
"postal_code": "678012302",
"telephone_number": "620-225-6095",
"fax_number": "620-225-6578"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1801 N 14TH AVE",
"city": "DODGE CITY",
"state": "KS",
"postal_code": "678012302",
"telephone_number": "620-225-6095",
"fax_number": "620-225-6578"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WADE",
"first_name": "GRACE",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-08-22",
"last_updated": "2020-08-22",
"certification_date": "2020-08-22",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "KS",
"license": "1-103349",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "rxm.07817@store.walgreens.com",
"affiliation": "N",
"endpointDescription": "Email",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "Email",
"address_1": "1801 N 14th Ave",
"city": "Dodge City",
"state": "KS",
"country_code": "US",
"postal_code": "678012302",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Dodge City, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.