Ty C. Wade, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

4012-012 Issued in WI

Practice address

620 E. Green Bay Ave.
Suite 104
Saukville, WI 53080

Phone

(262) 284-0022

Fax

(262) 268-0715

NPI assigned

Jan 30, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Specialty

Chiropractic

Education

Palmer College Chiropractic - Davenport, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Saukville Chiropractic Wellness Center Inc.

  • Chiropractor
  • Saukville, WI
  • NPI 1245407568
  Medicare reassignment NPD Authorized official
• Allied Health of Wisconsin, SC

  dba Allied Health Chiropractic Centers

  • Chiropractor
  • Wausau, WI
  • NPI 1487605051
  NPD (past)
• Oscoda Area Chiropractic Center Inc

  • Chiropractor
  • Oscoda, MI
  • NPI 1629276456
  NPD (past)

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716336000000",
    "number": "1922145101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 E. GREEN BAY AVE.",
            "address_2": "SUITE 104",
            "city": "SAUKVILLE",
            "state": "WI",
            "postal_code": "53080",
            "telephone_number": "262-284-0022",
            "fax_number": "262-268-0715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 E. GREEN BAY AVE.",
            "address_2": "SUITE 104",
            "city": "SAUKVILLE",
            "state": "WI",
            "postal_code": "53080",
            "telephone_number": "262-284-0022",
            "fax_number": "262-268-0715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADE",
        "first_name": "TY",
        "middle_name": "C.",
        "name_prefix": "Mr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-30",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "4012-012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38950300",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC",
            "identifier": "202500022",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACN",
            "identifier": "649385",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WEA",
            "identifier": "202500022",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WPPN",
            "identifier": "202500022",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "389-50300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Margaret R Techtman, RN
• Calvin Donald Thomas, P.T.
• Kelly Thompson
• Village of Saukville (Saukville Fire Department and Emergency Squad)
• Tami Brianna Wade, LMT 3708-146
• Wal-Mart Stores East LP (Vision Center 30-1650)
• Wal-Mart Stores East LP (Wal-Mart Pharmacy 10-1650)
• Walgreen Co (Walgreens #02110)
• Matthew D Weege, R.PH.
• Karen L Wysocki

• Chiropractor in Saukville, WI
• Providers in Saukville, WI by specialty
• Chiropractor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.