Individual provider Active NPI

Sandra M Wade, APN

  • Family Nurse Practitioner
  • Oak Ridge, TN
National Provider Identifier
1811966484
Registry record updated Jun 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APN0000005322 Issued in TN
Practice address
723 Emory Valley Rd
Oak Ridge, TN 37830-7017
Phone
(865) 748-2549
Fax
(865) 248-8203
NPI assigned
Mar 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APN0000005322 TN Primary

Addresses

Primary practice location

723 Emory Valley Rd
Oak Ridge, TN 37830-7017

Mailing address

1225 E Weisgarber Rd Ste 200
Knoxville, TN 37909-2675
Phone (865) 584-4747

Other practice location 1

2415 N Gateway Ave
Harriman, TN 37748-8609
Phone (865) 882-2002

Other practice location 2

933 W Race St
Kingston, TN 37763-2123
Phone (865) 882-0105

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
41431TNMDPharmacist
5322TNMDPharmacist
APN0000005322TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group PLLC PastSince Mar 24, 2024 Accepting new patients
Summit Medical Group,PLLC Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1142467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559865600000",
    "number": "1811966484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 E WEISGARBER RD STE 200",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379092675",
            "telephone_number": "865-584-4747",
            "fax_number": "865-584-1363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "723 EMORY VALLEY RD",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "378307017",
            "telephone_number": "865-748-2549",
            "fax_number": "865-248-8203"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2415 N Gateway Ave",
            "address_purpose": "LOCATION",
            "city": "Harriman",
            "state": "TN",
            "postal_code": "377488609",
            "country_code": "US",
            "telephone_number": "865-882-2002",
            "fax_number": "865-590-0475",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "933 W Race St",
            "address_purpose": "LOCATION",
            "city": "Kingston",
            "state": "TN",
            "postal_code": "377632123",
            "country_code": "US",
            "telephone_number": "865-882-0105",
            "fax_number": "865-882-0667",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WADE",
        "first_name": "SANDRA",
        "middle_name": "M",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-16",
        "last_updated": "2019-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "APN0000005322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Ridge, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.