Active NPI
Mitchell-Lee Wade, DC
- Chiropractor
- Tyrone, GA
National Provider Identifier
1477163244
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- CHIR010398
- Practice address
- 140 Howell Rd Ste D
Tyrone, GA 30290-2095 - Phone
- (770) 740-5000
- NPI assigned
- Aug 5, 2020
- Last updated
- May 5, 2023
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | CHIR010398 | GA | Primary |
Addresses
Primary practice location
140 Howell Rd Ste D
Tyrone, GA 30290-2095
Mailing address
10 Horizon HL
Newnan, GA 30265-5659
Phone (404) 797-0092
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wade Family Chiropractic LLC | Chiropractor | Current | Accepting new patients |
Locations
140 Howell Rd
Ste D
Tyrone, GA 30290
Phone (770) 740-5000
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Chiropractor
- Tyrone, GA
- NPI 1134807928
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1596585600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1683244800000",
"number": "1477163244",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10 HORIZON HL",
"city": "NEWNAN",
"state": "GA",
"postal_code": "302655659",
"telephone_number": "404-797-0092"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "140 HOWELL RD STE D",
"city": "TYRONE",
"state": "GA",
"postal_code": "302902095",
"telephone_number": "770-740-5000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WADE",
"first_name": "MITCHELL-LEE",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-08-05",
"last_updated": "2023-05-05",
"certification_date": "2023-05-05",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "GA",
"license": "CHIR010398",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tyrone, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.