Taylor J. Wade, MS,LAT, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

1517 Issued in AZ

Practice address

8600 E Rockcliff Rd
Tucson, AZ 85750-9733

Phone

(520) 749-9655

NPI assigned

Mar 31, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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.

• Dickson Diveley Midwest Orthopaedic Clinic LLC

  • Orthopaedic Surgery Physician
  • Leawood, KS
  • NPI 1669421509
  NPD (past)

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

{
    "created_epoch": "1459382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482537600000",
    "number": "1710340310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5441 N SWAN RD",
            "address_2": "APT 625",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857185434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8600 E ROCKCLIFF RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857509733",
            "telephone_number": "520-749-9655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADE",
        "first_name": "TAYLOR",
        "middle_name": "J.",
        "credential": "MS,LAT, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-31",
        "last_updated": "2016-12-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "AZ",
            "license": "1517",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PA",
            "license": "RT005978",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PENNSYLVANIA DEPARTMENT OF STATE BUREAU OF PROFESSIONAL AND OCCUPATIONAL AFFAIRS",
            "identifier": "RT005978",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARIZONA BOARD OF ATHLETIC TRAINING",
            "identifier": "1517",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth E Wack, M.D.
• Sophia Wacker, RBT
• Jenna Rose Wade
• Lana Gayle Wade, OD
• Natalie Christine Wade, PA-C
• Tiffani Wade, LPC, LPCC
• Rita Wadeea, MBCHB
• Erin Michelle Wadleigh, PT
• John Martin Wadleigh, D.O.
• Amy Wagelie Steffen, M.D.

• Athletic Trainer in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Athletic Trainer in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2016; 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.