Lina Deanne Wade, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

00000002289 Issued in TN

Practice address

7945 Wolf River Blvd
Germantown, TN 38138-1762

Phone

(901) 683-0055

Fax

(901) 922-6776

NPI assigned

Dec 16, 2018

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• The West Clinic P.C.

  • Specialist
  • Germantown, TN
  • NPI 1447276605
  NPD (past)

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

{
    "created_epoch": "1544918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544918400000",
    "number": "1912478066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1706 PANOHA DR",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381382234",
            "telephone_number": "901-517-3723",
            "fax_number": "901-922-6776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7945 WOLF RIVER BLVD",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381381762",
            "telephone_number": "901-683-0055",
            "fax_number": "901-922-6776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADE",
        "first_name": "LINA",
        "middle_name": "DEANNE",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-16",
        "last_updated": "2018-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "00000002289",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Val Y Vogt, MD
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• Amber June Wade, PA-C
• David Meron Wade, COTA
• Sam Wairiri, M.D
• Phillip Dewayne Waldrup, MD
• Walgreen Co (Walgreens #04312)
• Walgreen Co (Rite Aid # 7205)
• Walgreen Co (Walgreens #06037)

• Physical Therapist in Germantown, TN
• Providers in Germantown, TN by specialty
• Physical Therapist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2018; 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.