NPIMap

Individual provider Active NPI

Jim R Wade, MD

  • Internal Medicine Physician
  • Toccoa, GA
National Provider Identifier
1700860913
Registry record updated Jun 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
22664 Issued in GA
Practice address
58 Big a Road
Toccoa, GA 30577-6017
Phone
(706) 886-6819
Fax
(706) 282-5368
NPI assigned
Dec 1, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 22664 GA Primary

Addresses

Primary practice location

58 Big a Road
Toccoa, GA 30577-6017

Mailing address

58 Big a Road
Toccoa, GA 30577-6017
Phone (706) 886-6819

Other identifiers 2

IdentifierTypeStateIssuer
000001834AMedicaidGA
000222846AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040709000741 GA Practitioner - Emergency Medicine 3678461522 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Medical College of Georgia School of Medicine, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Stephens County Hospital Physician Group LLCGroup PAC ID 7012219306, 11 clinicians

Practice addresses (Care Compare)

218 Falls Rd
Toccoa, GA 30577-1631
Phone (706) 282-5840

Hospital & facility affiliations

  • Tugaloo Home Health Agency, an Amedisys Company Home health agency, Lavonia, GA, CCN 117036
  • Enhabit Home Health Home health agency, Gainesville, GA, CCN 117021
  • Pruitthealth Hospice-Gainesville Hospice, Gainesville, GA, CCN 111579
  • Stephens County Hospital Hospital, Toccoa, GA, CCN 110032
  • Northeast Georgia Medical Center, Inc Hospital, Gainesville, GA, CCN 110029
  • Northeast Georgia Medical Center Habersham Hospital, Demorest, GA, CCN 110041
  • Northside Hospital Forsyth Hospital, Cumming, GA, CCN 110005
  • Pruitthealth - Toccoa Nursing home, Toccoa, GA, CCN 115345

Merit-based Incentive Payment System (MIPS)

Final score
91.9 of 100Reported as individual
Quality
83.79
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
22664GAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Stephens County Hospital Physician Group LLC Internal Medicine CurrentSince Jul 11, 2021 Accepting new patients
Stephens County Hospital Physician Group, LLC CurrentSince Jul 11, 2021 Accepting new patients
Pruitthealth - Toccoa, LLC Past Accepting new patients
Stephens County Hospital Physician Group, LLC Past Accepting new patients

Locations

115 Rock Quarry Rd
Toccoa, GA 30577
Phone (706) 282-5815

58 Big a Rd
Toccoa, GA 30577
Phone (706) 886-3148

163 Hospital Dr
Toccoa, GA 30577
Phone (706) 282-4200

218 Falls Rd
Toccoa, GA 30577
Phone (706) 282-5840

Interoperability endpoints

  • Direct secure messaging: jim.wade.1@14936.direct.athenahealth.com

Organizations & group practices 4

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.

Hospital & facility affiliations 8

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": "1133395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435190400000",
    "number": "1700860913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "58 BIG A ROAD",
            "city": "TOCCOA",
            "state": "GA",
            "postal_code": "305776017",
            "telephone_number": "706-886-6819",
            "fax_number": "706-282-5368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "58 BIG A ROAD",
            "city": "TOCCOA",
            "state": "GA",
            "postal_code": "305776017",
            "telephone_number": "706-886-6819",
            "fax_number": "706-282-5368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADE",
        "first_name": "JIM",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-01",
        "last_updated": "2015-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "22664",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000001834A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000222846A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Toccoa, GA

Sources for this page

Verify at the official NPI Registry.