Individual provider Active NPI

Kirsten Angelique Wade, PNP

  • Pediatric Nurse Practitioner
  • Arlington, TX
National Provider Identifier
1891711552
Registry record updated Jan 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
AP122926 Issued in TX
Practice address
6109 S Cooper St
Arlington, TX 76001-5814
Phone
(866) 492-5008
NPI assigned
Jul 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X AP122926 TX Primary

Addresses

Primary practice location

6109 S Cooper St
Arlington, TX 76001-5814

Mailing address

803 Sierra Ave
Mansfield, TX 76063-1887
Phone (972) 249-5561

Other practice location 1

10325 Lake June Rd Ste 568
Dallas, TX 75217-5326
Phone (214) 247-6550

Other names 1

  • Kirsten Angelique Benford Former name

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
AP122926TXMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Singleton Associates PA Past Accepting new patients
Little Spurs Pediatric Urgent Care, 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": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738108800000",
    "number": "1891711552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "803 SIERRA AVE",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760631887",
            "telephone_number": "972-249-5561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6109 S COOPER ST",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760015814",
            "telephone_number": "866-492-5008"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10325 Lake June Rd Ste 568",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752175326",
            "country_code": "US",
            "telephone_number": "214-247-6550",
            "fax_number": "210-314-5044",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WADE",
        "first_name": "KIRSTEN",
        "middle_name": "ANGELIQUE",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-14",
        "last_updated": "2025-01-29",
        "certification_date": "2025-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "AP122926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIRSTEN",
            "last_name": "BENFORD",
            "middle_name": "ANGELIQUE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Arlington, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2025; 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.