Active NPI
Sara E Eades Wade, MS, RD, LDN
- Registered Dietitian
- Monticello, IL
National Provider Identifier
1740558428
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 164.005589
- Practice address
- 1000 Medical Center Dr
Monticello, IL 61856-2116 - Phone
- (217) 762-1904
- Fax
- (217) 762-1905
- NPI assigned
- Dec 8, 2011
- Last updated
- Dec 8, 2011
- 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 |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 164.005589 | IL | Primary |
Addresses
Primary practice location
1000 Medical Center Dr
Monticello, IL 61856-2116
Mailing address
1020 E 1150 North Rd
Bement, IL 61813-3510
Phone (217) 840-9464
Other names 1
- Sara E Eades
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 164.005589 | IL | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kirby Medical Center | Current | Accepting new patients | |
| Kirby Medical Center | Current | Accepting new patients |
Locations
1000 Medical Center Dr
Monticello, IL 61856
Phone (217) 762-1540
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Family Medicine Physician
- Monticello, IL
- NPI 1386635373
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1323302400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1323302400000",
"number": "1740558428",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1020 E 1150 NORTH RD",
"city": "BEMENT",
"state": "IL",
"postal_code": "618133510",
"telephone_number": "217-840-9464"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 MEDICAL CENTER DR",
"city": "MONTICELLO",
"state": "IL",
"postal_code": "618562116",
"telephone_number": "217-762-1904",
"fax_number": "217-762-1905"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EADES WADE",
"first_name": "SARA",
"middle_name": "E",
"name_prefix": "Mrs.",
"credential": "MS, RD, LDN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-12-08",
"last_updated": "2011-12-08",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "IL",
"license": "164.005589",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "SARA",
"last_name": "EADES",
"middle_name": "E",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Monticello, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.