Crystal Ann Wade (NPI# 1073173142, PAC ID# 5395072847) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
Nation Provider ID (NPI) | 1073173142 |
PAC ID by PECOS | 5395072847 |
Professional Enrollment ID | I20190807001360 |
Full Name | Crystal Ann Wade |
Organization Legal Name | HUGHSTON CLINIC SOUTHEAST PC |
Address |
1895 Kingsley Ave Suite 300 Orange Park FL 32073-4453 |
Phone Number | 9043758850 |
Gender | F |
Graduation Year | 2019 |
Primary Specialty | NURSE PRACTITIONER |
Group Practice PAC ID | 9234423971 |
Number of Group Practice Members | 44 |
Accepts Medicare Assignment | Y |
Claim Control Number (CCN) | Legal Business Name |
---|---|
100226 | ORANGE PARK MEDICAL CENTER |
Address | Phone | Organization |
---|---|---|
1895 Kingsley Ave, Suite 300, Orange Park, FL 32073-4453 | 9043758850 | HUGHSTON CLINIC SOUTHEAST PC |
2001 Kingsley Ave, Orange Park, FL 32073-5148 | 9046398500 | HUGHSTON CLINIC SOUTHEAST PC |
Organization Legal Name | HUGHSTON CLINIC SOUTHEAST PC |
Physicians | 44 |
Name | Specialty | Organization | Address |
---|---|---|---|
Lindsey Allison Baroch | Physician Assistant | Hughston Clinic Southeast PC | 3625 University Blvd S, Memorial Hospital, Jacksonville, FL 32216-4207 |
Rebecca Catherine Hanna | Physician Assistant | Hughston Clinic Southeast PC | 1401 W Seminole Blvd, Central Florida Regional Hospital, Sanford, FL 32771-6743 |
John Simonson IIi | Physician Assistant | Hughston Clinic Southeast PC | 309 N Mangoustine Ave, Unit G Triple County Medical Condominium, Sanford, FL 32771-1098 |
Quentin K Tanko | Orthopedic Surgery | Hughston Clinic Southeast PC | 3736 S 4th St, Terre Haute, IN 47802-5507 |
Paul Richard Bretton | Physician Assistant | Hughston Clinic Southeast PC | 2001 Kingsley Ave, Orange Park, FL 32073-5148 |
Robert M Harris | Orthopedic Surgery | Hughston Clinic Southeast PC | 631 Professional Dr, Suite 170, Lawrenceville, GA 30046-3392 |
Matthew Wahrendorff Deweese | Nurse Practitioner | Hughston Clinic Southeast PC | 3443 Dickerson Pike, Suite 190, Nashville, TN 37207-2533 |
Mark H Epps | Physician Assistant | Hughston Clinic Southeast PC | 631 Professional Dr, Suite 170, Lawrenceville, GA 30046-3392 |
Matthew Combes | Physician Assistant | Hughston Clinic Southeast PC | 309 N Mangoustine Ave, Unit G Triple County Medical Condominium, Sanford, FL 32771-1098 |
Nolan M. Renner | Physician Assistant | Hughston Clinic Southeast PC | 1000 Mar Walt Dr, Fort Walton Beach Medical Center, Fort Walton Beach, FL 32547-6708 |
Street Address |
1895 KINGSLEY AVE SUITE 300 |
City | ORANGE PARK |
State | FL |
Zip | 32073-4453 |
Name | Specialty | Organization | Address |
---|---|---|---|
Kathleen M Ruhlin | Physician Assistant | Orange Park Acute Trauma LLC | 1895 Kingsley Ave, Suite 300, Orange Park, FL 32073-4453 |
Thomas A Lupoli | Allergy/immunology | Allergy and Asthma Specialists of North Florida Pa | 1895 Kingsley Ave, Suite 401, Orange Park, FL 32073-4453 |
Wendy L Chambers | Physician Assistant | Orange Park Acute Trauma LLC | 1895 Kingsley Ave, Suite 300, Orange Park, FL 32073-4453 |
Angela L Karulak | Nurse Practitioner | Orange Park Acute Trauma LLC | 1895 Kingsley Ave, Suite 300, Orange Park, FL 32073-4453 |
Dennis D Dewey | Neurology | 1895 Kingsley Ave, Suite 805, Orange Park, FL 32073-4410 | |
Patrick J De Marco | Allergy/immunology | Allergy and Asthma Specialists of North Florida Pa | 1895 Kingsley Ave, Suite 401, Orange Park, FL 32073-4453 |
Yvette L Sims | Nurse Practitioner | Orange Park Acute Trauma LLC | 1895 Kingsley Ave, Suite 300, Orange Park, FL 32073-4453 |
Jon Robert Brown | General Surgery | Orange Park Acute Trauma LLC | 1895 Kingsley Ave, Suite 300, Orange Park, FL 32073-4453 |
David Mosborg | Otolaryngology | 1895 Kingsley Ave, Suite 703, Orange Park, FL 32073-4410 | |
Justin Charles Woods | Orthopedic Surgery | Hughston Clinic Southeast PC | 1895 Kingsley Ave, Suite 300, Orange Park, FL 32073-4453 |
Find all physicians in the same address |
Name | Specialty | Organization | Address |
---|---|---|---|
Rahman Karimi | Internal Medicine | Mcci Group Holdings LLC | 8 Blanding Blvd, Suite 20, Orange Park, FL 32073-2202 |
Carlos R Villa | Optometry | Myeyedr Optometry of Florida, LLC | 28 Blanding Blvd, Orange Park, FL 32073-2202 |
Robert Morris | Chiropractic | 1871 Wells Rd, Orange Park, FL 32073-2351 | |
Ali Tabatabai | Optometry | Family First Vision Care Pllc | 1911 Wells Rd, Suite 6, Orange Park, FL 32073-2372 |
Darren R Blom | Optometry | Family First Vision Care Pllc | 1911 Wells Rd, Suite 6, Orange Park, FL 32073-2372 |
Shaila N Williston | Family Practice | 1700 Wells Rd, Suite 27, Orange Park, FL 32073-2374 | |
Joseph N Salameh | Chiropractic | Jns Physicians Group LLC | 1700 Wells Rd, Orange Park, FL 32073-2374 |
Marcus Decarvalho | Psychiatry | 1677 Wells Rd, Suite A, Orange Park, FL 32073-2383 | |
Blake Bazel | Psychologist, Clinical | 1677 Wells Rd, Suite A, Orange Park, FL 32073-2383 | |
Hewell B Eaves | Optometry | Mack Eye Care Pa | 88 Blanding Blvd, Orange Park, FL 32073-2601 |
Find all physicians in zip 32073 |
City | ORANGE PARK |
Zip Code | 32073 |
Specialty | NURSE PRACTITIONER |
City + Specialty | ORANGE PARK + NURSE PRACTITIONER |
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Data Provider | Centers for Medicare & Medicaid Services (CMS) |
Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.