Active NPI
Simon Wade, PT, DPT
- Physical Therapist
- Clearwater, FL
National Provider Identifier
1811604010
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT39496
- Practice address
- 1661 Rainbow Dr
Clearwater, FL 33755-6438 - Phone
- (727) 442-7500
- NPI assigned
- Oct 28, 2022
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT39496 | FL | Primary |
Addresses
Primary practice location
1661 Rainbow Dr
Clearwater, FL 33755-6438
Mailing address
1825 East Dr
Clearwater, FL 33755-2254
Phone (727) 481-1828
Other practice location 1
37490 US Highway 19 N Ste A
Palm Harbor, FL 34684-1001
Phone (727) 888-3908
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT39496 | FL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1666915200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1666915200000",
"number": "1811604010",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1825 EAST DR",
"city": "CLEARWATER",
"state": "FL",
"postal_code": "337552254",
"telephone_number": "727-481-1828"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1661 RAINBOW DR",
"city": "CLEARWATER",
"state": "FL",
"postal_code": "337556438",
"telephone_number": "727-442-7500"
}
],
"practiceLocations": [
{
"address_1": "37490 US Highway 19 N Ste A",
"address_purpose": "LOCATION",
"city": "Palm Harbor",
"state": "FL",
"postal_code": "346841001",
"country_code": "US",
"telephone_number": "727-888-3908",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WADE",
"first_name": "SIMON",
"credential": "PT, DPT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-10-28",
"last_updated": "2022-10-28",
"certification_date": "2022-10-27",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "PT39496",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clearwater, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.