Active NPI
Patricia Wade
- Physical Therapist
- Southfield, MI
National Provider Identifier
1578065173
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5501001701
- Practice address
- 16001 W 9 Mile Rd
Southfield, MI 48075-4818 - Phone
- (248) 849-3465
- NPI assigned
- Feb 28, 2018
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 5501001701 | MI | Primary |
Addresses
Primary practice location
16001 W 9 Mile Rd
Southfield, MI 48075-4818
Mailing address
38743 Cheshire Dr
Northville, MI 48167-9038
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5501001701 | MI | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1519776000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1519776000000",
"number": "1578065173",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "38743 CHESHIRE DR",
"city": "NORTHVILLE",
"state": "MI",
"postal_code": "481679038"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16001 W 9 MILE RD",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480754818",
"telephone_number": "248-849-3465"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WADE",
"first_name": "PATRICIA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-02-28",
"last_updated": "2018-02-28",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MI",
"license": "5501001701",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Southfield, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.