CRYSTAL WADE (NPI# 1326483405) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326483405 |
| Entity Type | Individual |
| Full Name | CRYSTAL WADE |
| Credential | LDO |
| Practice Address |
1240 Highway 54 W 306 Fayetteville GA 30214-4557 |
| Mailing Address |
7492 Parkland Bnd Fairburn GA 30213-5422 |
| Practice Telephone | 6783047129 |
| Practice Fax Number | 8775437919 |
| Mailing Telephone | 6787771824 |
| Enumeration Date | 2013-05-02 |
| Last Update Date | 2014-05-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 156FC0800X |
Technician/Technologist Specialization: Contact Lens |
LDO002220 | GA | Eye and Vision Services Providers |
| N | 156FC0801X |
Technician/Technologist Specialization: Contact Lens Fitter |
LDO002220 | GA | Eye and Vision Services Providers |
| Y | 156FX1800X |
Technician/Technologist Specialization: Optician |
LDO002220 | GA | Eye and Vision Services Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730701855 | Crystal Wade | Social Worker | 10291 N Meridian St Ste 250, Indianapolis, IN 46290-1076 | 2020-05-12 |
| 1073173142 | Crystal Ann Wade | Nurse Practitioner | 2277 Eagle Harbor Pkwy, Fleming Island, FL 32003-7306 | 2019-06-19 |
| Street Address |
1240 HIGHWAY 54 W 306 |
| City | FAYETTEVILLE |
| State | GA |
| Zip Code | 30214-4557 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912944828 | Howard J Silk | Allergy & Immunology | 1240 Highway 54 W, Building 300 Suite 310, Fayetteville, GA 30214-4557 | 2006-05-31 |
| 1851831507 | Premier Medical Supply | Durable Medical Equipment & Medical Supplies | 1240 Highway 54 W, Suite 504, Fayetteville, GA 30214-4557 | 2017-02-28 |
| 1760848980 | South Atlanta Integrative Medicine | Family Medicine | 1240 Highway 54 W, Building 700, Suite 700, Fayetteville, GA 30214-4557 | 2016-01-04 |
| 1548697196 | South Atlanta Ear Nose & Throat, PC | Specialist | 1240 Highway 54 W, Bldg 700, Ste 710, Fayetteville, GA 30214-4557 | 2013-09-27 |
| 1588097612 | Fang Helen Yu | Nurse Practitioner | 1240 Highway 54 W, Building 300, Suite 310, Fayetteville, GA 30214-4557 | 2013-08-13 |
| 1356773436 | Medalert,llc | Clinical Medical Laboratory | 1240 Highway 54 W, Suite 102, Fayetteville, GA 30214-4557 | 2013-07-31 |
| 1891040622 | Home Medical Professionals | Durable Medical Equipment & Medical Supplies | 1240 Highway 54 W, Suite 303, Fayetteville, GA 30214-4557 | 2012-07-18 |
| 1942560875 | Hearing Aid Services of Atlanta LLC | Clinic/Center | 1240 Highway 54 W, Fayetteville, GA 30214-4557 | 2012-05-25 |
| 1386917995 | Lisa Jan Merritt | Family Medicine | 1240 Highway 54 W, Building 700, Suite 700, Fayetteville, GA 30214-4557 | 2012-02-13 |
| 1265703003 | Hearing Aid Services of Atlanta, LLC | Hearing Instrument Specialist | 1240 Highway 54 W, Ste. 604, Fayetteville, GA 30214-4557 | 2012-01-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548872468 | Phyllis Kelly Wood | Nurse Practitioner | 217 Banks Rd, Suite 31, Fayetteville, GA 30214 | 2020-08-21 |
| 1073139317 | Tyisha Salter Scott | Counselor | 110 Habersham Drive, Suite 142, Fayetteville, GA 30214 | 2020-06-23 |
| 1194341412 | Camille Franncine Bolton | Physical Therapist | 500 Floy Farr Parkway, Suite 303, Fayetteville, GA 30214 | 2020-06-23 |
| 1205465895 | Gillian Vaughan Heard | Physician Assistant | 1275 Ga-54 #201, Fayetteville, GA 30214 | 2020-04-06 |
| 1881234557 | Peach Fits,inc | Mastectomy Fitter | 285 Glynn Street South, Suites 102 and 104, Fayetteville, GA 30214 | 2020-01-10 |
| 1255981072 | Delta Healthcare Providers | Clinic/Center | 1275 W Lanier Ave, #200, Fayetteville, GA 30214 | 2019-09-13 |
| 1861965592 | Hierarchy for Wellness | Specialist | 805 S Glynn St Bldg 127 142, Fayetteville, GA 30214 | 2019-01-04 |
| 1356810634 | Fayette Dental Group PC | Clinic/Center | 720 W Lanier Ave, Fayetteville, GA 30214 | 2018-11-16 |
| 1891263299 | Mattie Mae Farmer Clark | Specialist/Technologist, Other | Piedmont Fayette Hospital, 1255 Highway 54 West, Fayetteville, GA 30214 | 2018-11-05 |
| 1093293607 | Allyson Holland | Pharmacist | 880 Highway 85 South, Fayetteville, GA 30214 | 2018-08-06 |
| Find all providers in zip 30214 | ||||
| Taxonomy Code | 156FX1800X |
| Grouping | Eye and Vision Services Providers |
| Classification | Technician/Technologist |
| Specialization | Optician |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477185205 | Dale A Klauss | Technician/Technologist | 294 Kenwood Rd Ste A, Fayetteville, GA 30214-3451 | 2020-02-10 |
| 1720446776 | Wal-mart Store East, Lp | Technician/Technologist | 2820 Gillespie St., Fayetteville, NC 28306 | 2016-02-05 |
| 1548653967 | National Vision, Inc. | Technician/Technologist | 105 Pavilion Pkwy, Fayetteville, GA 30214-4098 | 2015-03-10 |
| 1992082945 | Lil' Eyewear Outlet | Technician/Technologist | 120 Georgia Ave E, Fayetteville, GA 30214-1616 | 2011-11-04 |
| 1346401650 | Traci L Wyatt | Technician/Technologist | 104 W Colt Square Dr, Suite 2, Fayetteville, AR 72703-2834 | 2008-06-19 |
| 1518155712 | Wavely Lee Sledge | Technician/Technologist | 160 Bienville Dr, Fayetteville, NC 28311-9335 | 2007-10-12 |
| 1518169127 | Christina Lynn Doty | Technician/Technologist | 1800 N Skibo Rd St, 148 A, Fayetteville, NC 28303 | 2007-06-05 |
| 1518183896 | Richard E Reichert | Technician/Technologist | 5924 Cliffdale Rd Ste 112a, Fayetteville, NC 28314-2100 | 2007-04-17 |
| 1184773608 | Gold Optical Enterprise Inc | Technician/Technologist | 1635 Owen Dr, Fayetteville, NC 28304-3425 | 2007-01-10 |
| 1710388210 | America's Best Contacts & Eyeglasses | Technician/Technologist | 5075 Morganton Rd, Ste 9b, Fayetteville, NC 28314-1587 | 2014-09-16 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 30214 |
Please comment or provide details below to improve the information on CRYSTAL WADE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.