Individual provider Active NPI

Robert Brian Wade, D.C.

  • Chiropractor
  • Weatherford, OK
National Provider Identifier
1982804605
Registry record updated Jul 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3711 Issued in OK
Practice address
500 N Washington St Ste 3
Weatherford, OK 73096-5700
Phone
(580) 774-0611
Fax
(580) 774-0644
NPI assigned
Jul 20, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3711 OK Primary

Addresses

Primary practice location

500 N Washington St Ste 3
Weatherford, OK 73096-5700

Mailing address

500 N Washington St Ste 3
Weatherford, OK 73096-5700
Phone (580) 774-0611

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3711OKMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Wade Chiropractic Clinic Inc Chiropractor PastSince Jan 31, 2005 Accepting new patients
Traditions Hospice of Elk City, LLC PastSince May 1, 2020 Accepting new patients
Noble Chiropractic Center P.C. Chiropractor PastSince Aug 6, 2004 Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1184889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279670400000",
    "number": "1982804605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 N WASHINGTON ST STE 3",
            "city": "WEATHERFORD",
            "state": "OK",
            "postal_code": "730965700",
            "telephone_number": "580-774-0611",
            "fax_number": "580-774-0644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 N WASHINGTON ST STE 3",
            "city": "WEATHERFORD",
            "state": "OK",
            "postal_code": "730965700",
            "telephone_number": "580-774-0611",
            "fax_number": "580-774-0644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADE",
        "first_name": "ROBERT",
        "middle_name": "BRIAN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-20",
        "last_updated": "2010-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OK",
            "license": "3711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Weatherford, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2010; 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.