NPIMap

Organization Active NPI

Stedman - Wade Health Services, Inc

Doing business as Wade Family Medical Center Adult Health

  • Community Health Clinic/Center
  • Fayetteville, NC
National Provider Identifier
1912639808
Registry record updated May 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Clinic/CenterTaxonomy code 261QC1500X
Legal business name
STEDMAN - WADE HEALTH SERVICES, INC
Doing business as
Wade Family Medical Center Adult Health
Practice address
1235 Ramsey St Ste B
Fayetteville, NC 28301-4401
Phone
(910) 433-3770
Fax
(910) 307-3951
NPI assigned
Jun 29, 2022
Last updated
May 4, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
STEDMAN - WADE HEALTH SERVICES, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 4, 2023

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

Authorized official

Name
Melva Leonor Jackson
Title
Program Support
Phone
(910) 483-6694

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Clinic/Center 261QC1500X Primary

Addresses

Primary practice location

1235 Ramsey St Ste B
Fayetteville, NC 28301-4401

Mailing address

PO Box 449
Wade, NC 28395-0449
Phone (910) 483-6694

Other names 1

  • WADE FAMILY MEDICAL CENTER ADULT HEALTH Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221209000161 NC Part B Supplier - Clinic/Group Practice 0042205189 Receives reassigned benefits from 4 practitioners
Practice locations: Fayetteville, NC

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Part of
Stedman-Wade Ealth Servic

Locations

1235 Ramsey St
Ste B
Fayetteville, NC 28301
Phone (910) 433-3770

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/7912/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1656460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683158400000",
    "number": "1912639808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 449",
            "city": "WADE",
            "state": "NC",
            "postal_code": "283950449",
            "telephone_number": "910-483-6694",
            "fax_number": "910-483-2215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1235 RAMSEY ST STE B",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283014401",
            "telephone_number": "910-433-3770",
            "fax_number": "910-307-3951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEDMAN - WADE HEALTH SERVICES, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "STEDMAN - WADE HEALTH SERVICES, INC",
        "enumeration_date": "2022-06-29",
        "last_updated": "2023-05-04",
        "certification_date": "2023-05-04",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "MELVA",
        "authorized_official_middle_name": "LEONOR",
        "authorized_official_title_or_position": "PROGRAM SUPPORT",
        "authorized_official_telephone_number": "910-483-6694"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WADE FAMILY MEDICAL CENTER ADULT HEALTH",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "WADE FAMILY MEDICAL CENTER ADULT HEALTH",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.