Ivy Charlotte Wade

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

2530 S Commerce St BLDG B
Ardmore, OK 73401-5519

Phone

(802) 265-0485

Fax

(580) 226-3569

NPI assigned

Nov 22, 2022

Last updated

May 22, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1669075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684713600000",
    "number": "1972212561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2530 S COMMERCE ST BLDG C",
            "city": "ARDMORE",
            "state": "OK",
            "postal_code": "734015519",
            "telephone_number": "580-226-5048",
            "fax_number": "580-226-3569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2530 S COMMERCE ST BLDG B",
            "city": "ARDMORE",
            "state": "OK",
            "postal_code": "734015519",
            "telephone_number": "802-265-0485",
            "fax_number": "580-226-3569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADE",
        "first_name": "IVY",
        "middle_name": "CHARLOTTE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-11-22",
        "last_updated": "2023-05-22",
        "certification_date": "2023-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Case Manager/Care Coordinator in Ardmore, OK
• Providers in Ardmore, OK by specialty
• Case Manager/Care Coordinator in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2023; 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.