Individual provider Active NPI

James David Wade, CRNA

  • Certified Registered Nurse Anesthetist
  • Florence, SC
National Provider Identifier
1639223464
Registry record updated Jul 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
209006566 Issued in IL
Practice address
805 Pamplico Hwy
Florence, SC 29505-6019
Phone
(843) 674-5000
NPI assigned
Jan 22, 2007
Last updated
Jul 4, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 4, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 209006566 IL Primary

Addresses

Primary practice location

805 Pamplico Hwy
Florence, SC 29505-6019

Mailing address

PO Box 23321
New York, NY 10087-4321

Other identifiers 2

IdentifierTypeStateIssuer
041300787OtherILIL RN LICENSE NUMBER
209006566OtherILAPN LICENSE #

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address direct@direct.musc.edu Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070713000303 IL Practitioner - Certified Registered Nurse Anesthetist (Crna) 7214037647 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
G and G Anesthesia LLCGroup PAC ID 4981912607, 92 clinicians

Practice addresses (Care Compare)

3333 W Deyoung St
Suite 62959
Marion, IL 62959-5884
Phone (618) 998-7000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
209006566ILMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
G & G Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Oct 27, 2020 Accepting new patients
Southern Illinois Medical Services, NFP CurrentSince Jul 10, 2017 Accepting new patients
360 Anesthesia PLLC Nurse Anesthetist, Certified Registered CurrentSince Jun 1, 2023 Accepting new patients
Marshall Browning Hospital Association CurrentSince Mar 10, 2024 Accepting new patients
Marshall Browning Hospital Association CurrentSince Mar 10, 2024 Accepting new patients

Locations

1 Saint Anthonys Way
Alton, IL 62002
Phone (618) 233-6870

2601 W Main St
Carbondale, IL 62901
Phone (618) 351-7300

405 W Jackson St
Carbondale, IL 62901

4646 N Marine Dr
Chicago, IL 60640
Phone (773) 564-5102

900 N Washington St
Du Quoin, IL 62832
Phone (618) 542-1050

503 N Maple St
Effingham, IL 62401
Phone (217) 342-2121

3333 W Deyoung St
Marion, IL 62959
Phone (618) 998-7020

3 Erie Ct
Oak Park, IL 60302
Phone (708) 763-6200

Organizations & group practices 6

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783123200000",
    "number": "1639223464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23321",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100874321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 PAMPLICO HWY",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295056019",
            "telephone_number": "843-674-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADE",
        "first_name": "JAMES",
        "middle_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-22",
        "last_updated": "2026-07-04",
        "certification_date": "2026-07-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "209006566",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IL RN LICENSE NUMBER",
            "identifier": "041300787",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APN LICENSE #",
            "identifier": "209006566",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@direct.musc.edu",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "805 Pamplico Hwy",
            "city": "Florence",
            "state": "SC",
            "country_code": "US",
            "postal_code": "295056019",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Florence, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.