Active NPI
Lana Gayle Wade, OD
- Optometrist
- Tucson, AZ
National Provider Identifier
1740324995
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 504
- Practice address
- 6305 E Broadway Blvd
Tucson, AZ 85710-3502 - Phone
- (520) 795-7840
- Fax
- (520) 298-0847
- NPI assigned
- Feb 19, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 504 | AZ | Primary |
Addresses
Primary practice location
6305 E Broadway Blvd
Tucson, AZ 85710-3502
Mailing address
6305 E Broadway Blvd
Tucson, AZ 85710-3502
Phone (520) 795-7840
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171843200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1740324995",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6305 E BROADWAY BLVD",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857103502",
"telephone_number": "520-795-7840",
"fax_number": "520-298-0847"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6305 E BROADWAY BLVD",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857103502",
"telephone_number": "520-795-7840",
"fax_number": "520-298-0847"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WADE",
"first_name": "LANA",
"middle_name": "GAYLE",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "AZ",
"license": "504",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tucson, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.