Renee Lynn Wade, FNP

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

200851 Issued in NC

Practice address

70 Crape Myrtle Dr
Suite 104
Benson, NC 27504-8034

Phone

(919) 938-0260

Fax

(919) 938-0350

NPI assigned

Jan 10, 2006

Last updated

Feb 10, 2017By the provider in NPPES

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 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Interoperability endpoints

• Direct secure messaging: rspangler59389@memorialhermann.direct-ci.com

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

{
    "created_epoch": "1136851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486684800000",
    "number": "1508845413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 CRAPE MYRTLE DR",
            "address_2": "SUITE 104",
            "city": "BENSON",
            "state": "NC",
            "postal_code": "275048034",
            "telephone_number": "919-938-0260",
            "fax_number": "919-938-0350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 CRAPE MYRTLE DR",
            "address_2": "SUITE 104",
            "city": "BENSON",
            "state": "NC",
            "postal_code": "275048034",
            "telephone_number": "919-938-0260",
            "fax_number": "919-938-0350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADE",
        "first_name": "RENEE",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-10",
        "last_updated": "2017-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "200851",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSE PRACTITIONER REG #",
            "identifier": "75732",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSE PRACTITIONER LICENS",
            "identifier": "200851",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Patricia Jean Tuohy, LPC
• Ultimate Trucking Inc
• Paula Jeannese Uzuka, PH.D
• Pankaj Kirtikant Vyas, M.D.
• W.C. Adams (Doctors Vision Center)
• Walgreen Co (Walgreens #16156)
• Christopher Walker, D.D.S.
• Warren Drug Co of Benson Inc
• Monica Weathers
• Annah Shearin Wells, RPH

• Family Medicine Physician in Benson, NC
• Providers in Benson, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2017; 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.