Wade H Marion, PAC

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

101159 Issued in NC

Practice address

Medical Center Boulevard
Winston-Salem, NC 27157

Phone

(336) 716-6192

Fax

(336) 716-4318

NPI assigned

Dec 16, 2005

Sex

Male

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 8

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Wake Forest University Health Sciences

  • Multi-Specialty Clinic/Center
  • Winston Salem, NC
  • NPI 1003803032
  NPD (past)

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

{
    "created_epoch": "1134691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1385078400000",
    "number": "1659357176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MEDICAL CENTER BOULEVARD",
            "city": "WINSTON-SALEM",
            "state": "NC",
            "postal_code": "27157",
            "telephone_number": "336-716-6192",
            "fax_number": "336-716-4318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MEDICAL CENTER BOULEVARD",
            "city": "WINSTON-SALEM",
            "state": "NC",
            "postal_code": "27157",
            "telephone_number": "336-716-6192",
            "fax_number": "336-716-4318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARION",
        "first_name": "WADE",
        "middle_name": "H",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-16",
        "last_updated": "2013-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "101159",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "2469136",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VIRGINIA MEDICAID",
            "identifier": "1659357176",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "D5133",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "1659357176",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1659357176",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARTNERS",
            "identifier": "1659357176",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7010743",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SC MEDICAID",
            "identifier": "1608PA",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Angela Nicole Marinello, MMS, PA-C
• Chad Ryan Marion, DO
• Gail S Marion, PAC PHD
• Kristen Lee Marion, DPT
• Luke Lazarus Marion, RPH
• Mark H Nelson MD PA
• Jennifer Jones Markland, AGNP-C
• Brianna Elaine Marks, NP
• Malcolm Wernick Marks, MD
• Courtney Simmons Markwalter, ANP

• Medical Physician Assistant in Winston-Salem, NC
• Providers in Winston-Salem, NC by specialty
• Medical Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2013; 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.