Kreymohney Desiree Wade, SPECIALIST

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Practice address

122 S Main St Ste 110
Ann Arbor, MI 48104-1925

Phone

(734) 598-1564

Fax

(734) 407-8783

NPI assigned

Jun 7, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Specialty

Undefined Non-Physician Type (Specify)

Education

Other, 2014

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Elaborate You Hair Lash Aesthetics LLC

  • Prosthetic/Orthotic Supplier
  • Ann Arbor, MI
  • NPI 1871468637
  NPD

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

{
    "created_epoch": "1686096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789171200000",
    "number": "1659065019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 S MAIN ST STE 110",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481041925",
            "telephone_number": "734-598-1564",
            "fax_number": "734-407-8783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 S MAIN ST STE 110",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481041925",
            "telephone_number": "734-598-1564",
            "fax_number": "734-407-8783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADE",
        "first_name": "KREYMOHNEY",
        "middle_name": "DESIREE",
        "credential": "SPECIALIST",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-07",
        "last_updated": "2026-09-12",
        "certification_date": "2026-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shaneta Waddy
• Wade Counseling
• Alexis Wade
• Jenniah Wade
• Kathleen Wade, LMSW
• Ryan Wade, LLMSW
• Fanta Wafer
• Ryan Lucas Wagenschutz, CRNA
• Matthew A Waggoner, P.A.-C.
• Joleen Ann Wagner-Felkey, MSW

• Prosthetic/Orthotic Supplier in Ann Arbor, MI
• Providers in Ann Arbor, MI by specialty
• Prosthetic/Orthotic Supplier in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.