Elliot Louis Wade, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

12770 Issued in NV

Practice address

6970 W Patrick LN
Suite 140
Las Vegas, NV 89113-0269

Phone

(702) 450-1717

NPI assigned

Jul 30, 2008

Last updated

Feb 22, 2010By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Elliot Wade MD Inc

  • Internal Medicine Physician
  • Las Vegas, NV
  • NPI 1417283656
  Authorized official Same address or phone
• Theodore Affue M D Inc

  • Urology Physician
  • El Centro, CA
  • NPI 1316033459
  NPD

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

{
    "created_epoch": "1217376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266796800000",
    "number": "1487810321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3022 S DURANGO DR",
            "address_2": "SUITE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891174439",
            "telephone_number": "702-450-1717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6970 W PATRICK LN",
            "address_2": "SUITE 140",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891130269",
            "telephone_number": "702-450-1717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADE",
        "first_name": "ELLIOT",
        "middle_name": "LOUIS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-30",
        "last_updated": "2010-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A97317",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NV",
            "license": "12770",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1487810321",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Britney Wade
• Cynthia Sherell Wade
• Daisha Wade
• Datonya Wade
• Diana L Wade
• Eporre'Ya Wade
• Eric Wade
• Felesia Wade
• Geoffrey A Wade, MD
• Gineah A Wade

• Internal Medicine Physician in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Internal Medicine Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2010; 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.