Laura Katherine Wade, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

58932 Issued in AZ

Practice address

1600 W University Ave Ste 112
Flagstaff, AZ 86001-3154

Phone

(928) 223-4823

Fax

(202) 381-9567

NPI assigned

May 18, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Mar 14, 2022 through Mar 14, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1463529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704931200000",
    "number": "1801243902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 W UNIVERSITY AVE STE 112",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860013154",
            "telephone_number": "928-223-4823",
            "fax_number": "202-381-9567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 W UNIVERSITY AVE STE 112",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860013154",
            "telephone_number": "928-223-4823",
            "fax_number": "202-381-9567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADE",
        "first_name": "LAURA",
        "middle_name": "KATHERINE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-18",
        "last_updated": "2024-01-11",
        "certification_date": "2024-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "AZ",
            "license": "58932",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "58932",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan Dary Von Gerichten, DPT
• Thomas E Vorpahl, M.D.,P.C.
• Elizabeth Ann Vos, MA, BCBA, LBA
• Voytek Inc
• Peter H. Vu, PHARM.D
• Wadhams Apothecary Inc
• Barbara J Wagar, RPH
• Garth Wagenman, PT
• Stephanie Wagner, M.S. CCC-SLP
• Taylor Wahl-Fabrega, RD

• Family Medicine Physician in Flagstaff, AZ
• Providers in Flagstaff, AZ by specialty
• Family Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.