Active NPI
Jeri Wade, FNP
- Nurse Practitioner
- Auburn, ME
National Provider Identifier
1760479794
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128b(4) exclusion effective Mar 20, 2025.
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- AP081465
- Practice address
- 190 Stetson Rd
Auburn, ME 04210-7813 - Phone
- (207) 784-7388
- Fax
- (207) 795-2043
- NPI assigned
- Oct 4, 2005
- Last updated
- Jan 4, 2010
- 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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | AP081465 | ME | Primary |
Addresses
Primary practice location
190 Stetson Rd
Auburn, ME 04210-7813
Mailing address
190 Stetson Rd
Auburn, ME 04210-7813
Phone (207) 784-7388
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 251110099 | Medicaid | ME |
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)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AP081465 | ME | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1128384000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1262563200000",
"number": "1760479794",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "190 STETSON RD",
"city": "AUBURN",
"state": "ME",
"postal_code": "042107813",
"telephone_number": "207-784-7388",
"fax_number": "207-795-2043"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "190 STETSON RD",
"city": "AUBURN",
"state": "ME",
"postal_code": "042107813",
"telephone_number": "207-784-7388",
"fax_number": "207-795-2043"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WADE",
"first_name": "JERI",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-10-04",
"last_updated": "2010-01-04",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "ME",
"license": "AP081465",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "251110099",
"state": "ME"
}
],
"endpoints": [],
"other_names": []
}Other providers in Auburn, ME
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- Sarah A Wakefield, LCPC
- Wal-Mart Stores East LP (Walmart Pharmacy 10-1868)
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- Walgreen Co (Walgreens #19397)
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.