Individual provider Active NPI

Tasha Monique Wadley, M.D.

  • Pediatrics Physician
  • Cincinnati, OH
National Provider Identifier
1477949592
Registry record updated Jul 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
35.133512 Issued in OH
Practice address
3333 Burnet Ave
ML 5026
Cincinnati, OH 45229
Phone
(513) 636-7722
Fax
(513) 636-3737
NPI assigned
Apr 15, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Psychiatry & Neurology) Physician 2084A0401X 55964 KY
Pediatrics Physician 208000000X 35.133512 OH Primary

Addresses

Primary practice location

3333 Burnet Ave
ML 5026
Cincinnati, OH 45229

Mailing address

3333 Burnet Ave
MLC 2011
Cincinnati, OH 45229-3026
Phone (513) 636-7722

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180817001798 OH Practitioner - Pediatric Medicine 0244589638 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
55964KYMDAddiction Medicine (Psychiatry & Neurology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Metro Treatment of Kentucky, LP CurrentSince Apr 18, 2023 Accepting new patients
Children'S Hospital Medical Center Pediatrics CurrentSince Jul 7, 2018 Accepting new patients
Montgomery Pediatrics Incorporated Past Accepting new patients

Locations

3341 Solutions Ctr
Chicago, IL 60677

2001 Madison Ave
Covington, KY 41014
Phone (859) 444-4499

3430 Burnet Ave
Ofc
Cincinnati, OH 45229
Phone (513) 636-7722

3333 Burnet Ave
#5021
Cincinnati, OH 45229
Phone (513) 636-4225

3333 Burnet Ave
#2011
Cincinnati, OH 45229
Phone (513) 636-4506

3430 Burnet Ave
Cincinnati, OH 45229
Phone (513) 636-4651

3333 Burnet Ave
#5026
Cincinnati, OH 45229
Phone (513) 636-7722

3333 Burnet Ave
Cincinnati, OH 45229
Phone (513) 636-4200

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8872/brand/1/csg/1/fhir/r4

Organizations & group practices 3

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": "1429056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722211200000",
    "number": "1477949592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 BURNET AVE",
            "address_2": "MLC 2011",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452293026",
            "telephone_number": "513-636-7722",
            "fax_number": "513-636-3737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 BURNET AVE",
            "address_2": "ML 5026",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "45229",
            "telephone_number": "513-636-7722",
            "fax_number": "513-636-3737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADLEY",
        "first_name": "TASHA",
        "middle_name": "MONIQUE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-15",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084A0401X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "KY",
            "license": "55964",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35.133512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.