Anne C Wadham, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

12822 Issued in CA

Practice address

3200 Walford Ave
Eureka, CA 95503-4828

Phone

(707) 445-3443

NPI assigned

Apr 19, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

University of California, Davis School of Medicine, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence St Joseph Hospital Hospital, Eureka, CA, CCN 050006
• Providence Santa Rosa Memorial Hospital Hospital, Santa Rosa, CA, CCN 050174

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: awadham1648018@oc.providencedirect.org

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.

• Providence Medical Foundation

  • Family Medicine Physician
  • Brea, CA
  • NPI 1871607762
  Medicare reassignment Care Compare group NPD (past)
• Providence Medical Foundation

  • Family Medicine Physician
  • Anaheim, CA
  • NPI 1639715709
  NPD
• Providence Medical Foundation

  • Internal Medicine Physician
  • Santa Rosa, CA
  • NPI 1740584473
  NPD
• St. Joseph Health Northern California, LLC

  • General Acute Care Hospital
  • Eureka, CA
  • NPI 1609858950
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St. Joseph Health Northern California, LLC

  • General Acute Care Hospital
  • Santa Rosa, CA
  • NPI 1134152549
  Care Compare affiliation
• St. Joseph Health Northern California, LLC

  • Home Infusion Therapy Pharmacy
  • Eureka, CA
  • NPI 1568422319

  Hospital

  Care Compare affiliation
• St. Joseph Health Northern California, LLC

  • General Acute Care Hospital
  • Eureka, CA
  • NPI 1609858950
  Care Compare affiliation
• St. Joseph Health Northern California, LLC

  • General Acute Care Hospital
  • Eureka, CA
  • NPI 1891900635
  Care Compare affiliation

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

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637020800000",
    "number": "1821053984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 WALFORD AVE",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955034828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 WALFORD AVE",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955034828",
            "telephone_number": "707-445-3443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADHAM",
        "first_name": "ANNE",
        "middle_name": "C",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-19",
        "last_updated": "2021-11-16",
        "certification_date": "2021-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "12822",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "YYY49032Y",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "awadham1648018@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "3200 Walford Ave",
            "city": "Eureka",
            "state": "CA",
            "country_code": "US",
            "postal_code": "955034828",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sarah Vogel
• Allison Von Dreele
• Danielle Vonoch
• Jennifer Vu, RBT
• Jessica Rae Vulich, RN
• Heather Wadhams
• Lauren Suzanne Wagner
• Nichole Wagner
• Theresa Ann Wagner
• Zachary Wagner, MSN, APRN, NP-C

• Medical Physician Assistant in Eureka, CA
• Providers in Eureka, CA by specialty
• Medical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.