Wade Bror Clauson, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

6820 Issued in AK

Practice address

7411 Metzger Ave Unit B
Jber, AK 99506-2022

Phone

(907) 330-9779

NPI assigned

Mar 13, 2012

Last updated

Mar 13, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1331596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331596800000",
    "number": "1821363532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7411 METZGER AVE UNIT B",
            "city": "JBER",
            "state": "AK",
            "postal_code": "99506",
            "telephone_number": "907-330-9779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7411 METZGER AVE UNIT B",
            "city": "JBER",
            "state": "AK",
            "postal_code": "995062022",
            "telephone_number": "907-330-9779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLAUSON",
        "first_name": "WADE",
        "middle_name": "BROR",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-13",
        "last_updated": "2012-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "146N00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medical Technician, Basic",
            "state": "FL",
            "license": "EMT530361",
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "AK",
            "license": "6820",
            "primary": true
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "FL",
            "license": "PN5199765",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Doug Cho, M.D.
• Min Choi, DNP, RN, AGACNP-BC,
• Javier Cifuentes, MD
• Clairessa Ciupak, PHARMD
• Justin James Clark, M.D.
• Rachel Clayton
• Matthew Coddington, DPT
• Eric W Colegrove, O.D.
• Alix Ann Coleman, OTD, OTR/L
• Lindsey Tyler Colgan, RD

• Licensed Practical Nurse in Jber, AK
• Providers in Jber, AK by specialty
• Licensed Practical Nurse in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2012; 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.