Wade Pediatrics PC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

18036 Issued in OK

Legal business name

WADE PEDIATRICS PC

Practice address

3505 W Broadway
Muskogee, OK 74401

Phone

(918) 683-8442

Fax

(918) 683-8390

NPI assigned

Feb 13, 2006

Organization subpart

No

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

Authorized official

Name

Kevin F WadeNPI 1629135926

Title

Owner

Phone

(918) 683-8442

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kevin Francis Wade, M.D.

  • Pediatrics Physician
  • Ontario, OR
  • NPI 1629135926
  NPD (past) Authorized official
• Kristin S Coffman, ARNP

  • Nurse Practitioner
  • Muskogee, OK
  • NPI 1336410273
  NPD (past)
• Kellie Renee Swim, APRN

  • Family Nurse Practitioner
  • Tahlequah, OK
  • NPI 1518378371
  NPD (past)
• Rhonda Tootill, FNP

  • Critical Care Pediatric Nurse Practitioner
  • Muskogee, OK
  • NPI 1447677281
  NPD (past)

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

{
    "created_epoch": "1139788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1962475558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3505 W BROADWAY",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "74401",
            "telephone_number": "918-683-8442",
            "fax_number": "918-683-8390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3505 W BROADWAY",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "74401",
            "telephone_number": "918-683-8442",
            "fax_number": "918-683-8390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WADE PEDIATRICS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WADE",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "918-683-8442"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "OK",
            "license": "18036",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01837071",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vital Physical Therapy Services LLC
• Vitality Health Solutions, LLC
• Megan L Vitrano
• Danny Hoang Vu Vo, DPM
• Aparna Vuppala, MD
• Amber Marie Wade
• Billy Mitchel Wade II, D.C.
• Katrina Rae Wafford, RD/LD
• Brian William Wagnon, RN
• Wagoner Hospital Authority

• Pediatrics Physician in Muskogee, OK
• Providers in Muskogee, OK by specialty
• Pediatrics Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.