Brandy Wade, FNP-BC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

209.028623 Issued in IL

Practice address

2535 S King Dr
Chicago, IL 60616-4746

Phone

(312) 674-5972

NPI assigned

Dec 5, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: brandy.wade.1@18277.direct.athenahealth.com

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.

• Family Doc, Inc.

  • Family Medicine Physician
  • Chicago, IL
  • NPI 1700117942
  Medicare reassignment NPD
• Familydoc Urgent Care LLC

  • Urgent Care Clinic/Center
  • Chicago, IL
  • NPI 1245880715
  Medicare reassignment NPD
• Mind Revival Psych Inc

  • Psychiatric/Mental Health Nurse Practitioner
  • Chicago, IL
  • NPI 1043182280
  NPD (past)

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

{
    "created_epoch": "1701734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701734400000",
    "number": "1962279489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2535 S KING DR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606164746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2535 S KING DR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606164746",
            "telephone_number": "312-674-5972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADE",
        "first_name": "BRANDY",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-05",
        "last_updated": "2023-12-05",
        "certification_date": "2023-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.028623",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209.028623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wade Wellness, Inc.
• Andrew Wade, MB, BCH, BAO
• Arquette C Wade, MMS, PA-C
• Billy Wade Jr., L.C.S.W
• Bonnie Wade, L.C.S.W.
• Donna M. Wade
• Elizabeth Wade, LMT
• Erica Wade
• Erica D Wade, PH.D., LCPC, ACS
• Jennifer Wade, L.AC.

• Nurse Practitioner in Chicago, IL
• Providers in Chicago, IL by specialty
• Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.