KELLY WADE (NPI# 1811924723) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811924723 |
| Entity Type | Individual |
| Full Name | KELLY WADE |
| Credential | MD |
| Practice Address |
3401 Civic Center Blvd Children's Hospital of Philadelphia - Neonatology Philadelphia PA 19104-4319 |
| Mailing Address |
100 E Penn Sq 9th Floor Philadelphia PA 19107-3323 |
| Practice Telephone | 2155901944 |
| Practice Fax Number | 2155904454 |
| Mailing Telephone | 2674259232 |
| Mailing Fax Number | 2674259299 |
| Enumeration Date | 2006-06-27 |
| Last Update Date | 2013-04-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208000000X | Pediatrics | MD073505L | PA | Allopathic & Osteopathic Physicians |
| Y | 2080N0001X |
Pediatrics Specialization: Neonatal-Perinatal Medicine |
MD073505L | PA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | 1010911740001 | 05 | |
| NJ | 0032905 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346479870 | Kelly Ann Wade | Speech-Language Pathologist | 58 Blackberry Dr, Hudson, OH 44236-4700 | 2009-07-06 |
| 1396025698 | Kelly Jensen Wade | Psychologist | 130 Executive Center Pkwy, Fredericksburg, VA 22401-3100 | 2011-08-18 |
| 1679801740 | Kelly L Wade | Case Manager/Care Coordinator | 1400 Hudson St, Elkhart, IN 46516-2023 | 2009-11-30 |
| 1902025034 | Kelly Baker Wade | Nurse Anesthetist, Certified Registered | 877 Jefferson Ave, Memphis, TN 38103-2807 | 2007-04-25 |
| 1194842237 | Kelly Rae Wade | Acupuncturist | 1800 Westlake Ave N Ste 203, Seattle, WA 98109-2782 | 2007-03-23 |
| Street Address |
3401 CIVIC CENTER BLVD CHILDREN'S HOSPITAL OF PHILADELPHIA - NEONATOLOGY |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19104-4319 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467458463 | Jeffrey R Boris | Pediatrics | 3401 Civic Center Blvd, Children's Hospital of Philadelphia - Cardiology, Philadelphia, PA 19104-4319 | 2005-06-23 |
| 1932700259 | Rukhsar Karim Machiwalla | Physician Assistant | 3401 Civic Center Blvd, Philadelphia, PA 19104-4319 | 2020-11-03 |
| 1346840519 | Vanessa Leigh Jones | Nurse Practitioner | 3401 Civic Center Blvd, Philadelphia, PA 19104-4319 | 2020-10-27 |
| 1275131849 | Kelsey Ann Maher | Physician Assistant | 3401 Civic Center Blvd, Philadelphia, PA 19104-4319 | 2020-10-15 |
| 1437756020 | Jennifer-rose Eccles | Nurse Practitioner | 3401 Civic Center Blvd, Philadelphia, PA 19104-4319 | 2020-10-06 |
| 1891309787 | Morgan Mcmanus | Genetic Counselor, MS | 3401 Civic Center Blvd, Philadelphia, PA 19104-4319 | 2020-09-08 |
| 1891309456 | Abigail G Stefanides | Physician Assistant | 3401 Civic Center Blvd, Philadelphia, PA 19104-4319 | 2020-09-01 |
| 1124631247 | Abrar Khaled Alabdulhadi | Pediatrics | 3401 Civic Center Blvd, Philadelphia, PA 19104-4319 | 2020-08-28 |
| 1003427014 | Terrence Caldwell Jr. | Pharmacist | 3401 Civic Center Blvd, Philadelphia, PA 19104-4319 | 2020-08-13 |
| 1760093298 | Paige Emily Naschke | Nurse Practitioner | 3401 Civic Center Blvd, Philadelphia, PA 19104-4319 | 2020-08-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639770829 | Michelle Morris | Student in an Organized Health Care Education/Training Program | Dept. of Family Medicine & Community Health, 3737 Market, Philadelphia, PA 19104 | 2020-11-04 |
| 1346853041 | Spectrum Health Services, Inc. | Clinic/Center | 1415 South University Ave, Philadelphia, PA 19104 | 2020-08-24 |
| 1770104259 | Fatimah Sorefan-mangou | Student in an Organized Health Care Education/Training Program | 4 Maloney 3400 Spruce Street, Philadelphia, PA 19104 | 2020-05-06 |
| 1114548690 | Rebecca Blaguski | Registered Nurse | The Hospital of The University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104 | 2020-05-06 |
| 1952944175 | Rebecca Miriam Barmherzig | Psychiatry & Neurology | 3501 Civic Centre Blvd, 10th Flr Ctrb, Neurology, Philadelphia, PA 19104 | 2019-10-21 |
| 1891257101 | James Paul Byrne | Surgery | Penn Presbyterian Medical Center, Division of Trauma, S, 51 N. 39th Street, Suite 120, 1st Floor Medical Office, Philadelphia, PA 19104 | 2019-04-04 |
| 1093276453 | Lauren Shreve | Student in an Organized Health Care Education/Training Program | Department of Surgery, Surgery Education - Penn Health, 3400 Spruce Street, 4 Maloney, Philadelphia, PA 19104 | 2019-03-28 |
| 1285194282 | Lauren M Christie | Student in an Organized Health Care Education/Training Program | Penn Presbyterian Medical Center, 51 N. 39th Street, Philadelphia, PA 19104 | 2019-03-25 |
| 1114487683 | Sabrina Layne | Student in an Organized Health Care Education/Training Program | 3400 Spruce Street, 100 Centrex, Philadelphia, PA 19104 | 2019-03-21 |
| 1811457310 | Kia Lor | Student in an Organized Health Care Education/Training Program | Hospital of University of Pennsylvania, 3400 Spruce St., Philadelphia, PA 19104 | 2019-03-21 |
| Find all providers in zip 19104 | ||||
| Taxonomy Code | 2080N0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Neonatal-Perinatal Medicine |
| A pediatrician who is the principal care provider for sick newborn infants. Clinical expertise is used for direct patient care and for consulting with obstetrical colleagues to plan for the care of mothers who have high-risk pregnancies. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568656981 | Mario Zichella Jr. | Pediatrics | 1025 Walnut Street, Suite 700, Philadelphia, PA 19107-3121 | 2007-08-29 |
| 1235333774 | Andrea Freeman Duncan | Pediatrics | 3401 Civic Center Blvd Fl 2, Philadelphia, PA 19104-4319 | 2007-06-11 |
| 1831302603 | Folasade Ibironke Kehinde | Pediatrics | 160 E Erie Ave Dept Of, Philadelphia, PA 19134-1011 | 2007-05-08 |
| 1639204225 | Kirstie R Marcello | Pediatrics | 111 South 11th Street, 7th Floor College Building, Philadelphia, PA 19107 | 2007-02-22 |
| 1134286677 | Yanick Mary Vibert | Pediatrics | 230 North Broad Street, Mailstop 492, 10th Floor South Tower Neonatology Office, Philadelphia, PA 19102 | 2007-01-03 |
| 1164476842 | Karen Fritz | Pediatrics | St. Christopher's Hospital Erie Ave and Front St, Div of Neonatology, Philadelphia, PA 19131 | 2006-05-19 |
| 1043274376 | Daniel Henry Conway | Pediatrics | Front St and Erie Ave, St. Christopher's Hospital for Children, Philadelphia, PA 19134 | 2006-04-13 |
| 1720623200 | Stc Pediatrics LLC | Pediatrics | 3401 N Broad St, Philadelphia, PA 19140-5103 | 2019-11-08 |
| 1639713076 | Stc Pediatrics LLC | Pediatrics | 160 E Erie Ave, Philadelphia, PA 19134-1011 | 2019-10-29 |
| 1750863619 | Temple Faculty Practice Plan, Inc | Pediatrics | 3401 N Broad St, Philadelphia, PA 19140-5103 | 2018-09-06 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19104 |
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| 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.