Individual provider Active NPI

Thomas A. Wade Jr., MD

  • Internal Medicine Physician
  • Columbus, GA
National Provider Identifier
1861416059
Registry record updated May 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
16194 Issued in GA
Practice address
610 19TH St
Columbus, GA 31901-1528
Phone
(706) 322-7884
Fax
(706) 660-2145
NPI assigned
Jul 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 16194 GA Primary

Addresses

Primary practice location

610 19TH St
Columbus, GA 31901-1528

Mailing address

PO Box 9247
Columbus, GA 31908-9247
Phone (706) 322-7884

Other identifiers 3

IdentifierTypeStateIssuer
00144152FMedicaidGA
110054050OtherGARAIL ROAD MEDICARE
000144152JMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090210000086 GA Practitioner - Internal Medicine 3577648930 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
76194GAMDAnesthesiology Physician
16194GAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Francis Affiliated Services LLC CurrentSince Jan 1, 2016 Accepting new patients
St. Francis Psychiatrist ,LLC Current Accepting new patients
St Francis Affiliated Services LLC Internal Medicine CurrentSince Jan 1, 2016 Accepting new patients
St Francis Columbus Clinic LLC Internal Medicine Current Accepting new patients
St Francis Affiliated Services LLC Internal Medicine Current Accepting new patients
St Francis Physician Practices LLC Past Accepting new patients

Locations

3465 Macon Rd
Ste D
Columbus, GA 31907
Phone (706) 243-3051

610 19th St
Columbus, GA 31901
Phone (706) 322-7884

705 17th St
Columbus, GA 31901
Phone (706) 243-4404

Interoperability endpoints

  • Direct secure messaging: thomas.wade@sfhga.gadirect.net
  • Direct secure messaging: thomas.wade@gadirect.net

Organizations & group practices 6

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": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430870400000",
    "number": "1861416059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9247",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319089247",
            "telephone_number": "706-322-7884",
            "fax_number": "706-660-2145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 19TH ST",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319011528",
            "telephone_number": "706-322-7884",
            "fax_number": "706-660-2145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADE",
        "first_name": "THOMAS",
        "middle_name": "A.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2015-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "16194",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00144152F",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "110054050",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000144152J",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, GA

Sources for this page

Verify at the official NPI Registry.