NPIMap

Individual provider Active NPI

Blair Jones Wade, P.A.

  • Physician Assistant
  • Greenville, SC
National Provider Identifier
1730406000
Registry record updated Jun 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2110 Issued in SC
Practice address
200 Patewood Dr Ste C300
Greenville, SC 29615-6324
Phone
(864) 454-8272
Fax
(864) 454-2875
NPI assigned
Apr 27, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2110 SC Primary

Addresses

Primary practice location

200 Patewood Dr Ste C300
Greenville, SC 29615-6324

Mailing address

300 E McBee Ave FL 4
Greenville, SC 29601-2842
Phone (864) 522-8603

Other practice location 1

111 Doctors Dr
Greenville, SC 29605-5622
Phone (864) 797-7150

Other identifiers 2

IdentifierTypeStateIssuer
NP2898MedicaidSC
006520100MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bwade6801@direct.ghs.myhfn.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20141116000014 SC Practitioner - Physician Assistant 0042492274 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

200 Patewood Dr
Suite C300
Greenville, SC 29615-6324
Phone (864) 454-8272

210 Freeman Farm Rd
Duncan, SC 29334-9398
Phone (864) 968-5123

701 Grove Rd
Greenville, SC 29605-4210

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2110SCMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health University Medical Group CurrentSince Sep 8, 2014 Accepting new patients
Prisma Health University Medical Group CurrentSince Sep 8, 2014 Accepting new patients
Prisma Health University Medical Group Past Accepting new patients

Locations

22725 US Highway 76
Clinton, SC 29325
Phone (864) 833-9100

210 Freeman Farm Rd
Duncan, SC 29334
Phone (864) 968-5123

200 Fleetwood Dr
Easley, SC 29640
Phone (864) 442-7200

175 Patewood Dr
Greenville, SC 29615
Phone (864) 797-1000

300 E McBee Ave
Fl 4
Greenville, SC 29601
Phone (864) 522-8615

200 Patewood Dr
Ste C300
Greenville, SC 29615
Phone (864) 454-2852

1 Independence Pt
Ste 212
Greenville, SC 29615
Phone (864) 797-6306

701 Grove Rd
Fl 5
Greenville, SC 29605
Phone (864) 455-4411

111 Doctors Dr
Greenville, SC 29605
Phone (864) 242-4683

701 Grove Rd
Greenville, SC 29605
Phone (864) 454-2030

298 Memorial Dr
Seneca, SC 29672
Phone (864) 482-3100

Organizations & group practices 3

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 47

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

View all 47

NPI Registry JSON

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

{
    "created_epoch": "1272326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623715200000",
    "number": "1730406000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE FL 4",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012842",
            "telephone_number": "864-522-8603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 PATEWOOD DR STE C300",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296156324",
            "telephone_number": "864-454-8272",
            "fax_number": "864-454-2875"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 Doctors Dr",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "SC",
            "postal_code": "296055622",
            "country_code": "US",
            "telephone_number": "864-797-7150",
            "fax_number": "864-797-7155",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WADE",
        "first_name": "BLAIR",
        "middle_name": "JONES",
        "name_prefix": "Ms.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-27",
        "last_updated": "2021-06-15",
        "certification_date": "2021-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "2110",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP2898",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006520100",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bwade6801@direct.ghs.myhfn.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "bwade6801@direct.ghs.myhfn.org",
            "address_1": "200 Patewood Dr Ste C300",
            "city": "Greenville",
            "state": "SC",
            "country_code": "US",
            "postal_code": "296156324",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.