DR. JEFFREY SCOTT WADE (NPI# 1134219447) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134219447 |
| Entity Type | Individual |
| Full Name | DR. JEFFREY SCOTT WADE |
| Credential | O.D. |
| Practice Address |
4024 Elkhart Rd Ste 23 Goshen IN 46526-5803 |
| Mailing Address |
50571 Prestonwood Ct Granger IN 46530-4963 |
| Practice Telephone | 5748755042 |
| Practice Fax Number | 5748755171 |
| Mailing Telephone | 5742740117 |
| Mailing Fax Number | 5748755171 |
| Enumeration Date | 2006-10-15 |
| Last Update Date | 2013-07-31 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 18002947B | IN | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 200204300A | 05 | |
| IN | TAX ID# | 35-2132356 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073023982 | Jeffrey Wade | Case Manager/Care Coordinator | 104 E Haven Ct, Kathleen, GA 31047-3113 | 2017-10-05 |
| 1649286592 | Jeffrey Wade | Counselor | 8221 S 700 E, Sandy, UT 84070-0507 | 2006-07-31 |
| 1114967775 | Jeffrey Darrell Wade | Specialist | 3686 Grandview Pkwy Ste 510, Birmingham, AL 35243-3509 | 2006-06-08 |
| 1093773616 | Jeffrey F Wade | Specialist | 801 E Walnut St Apt 1403, Pasadena, CA 91101-5606 | 2006-05-03 |
| 1679517833 | Jeffrey Trent Wade | Radiology | 490 Dunlop Ln, Clarksville, TN 37040-5007 | 2006-06-16 |
| Street Address |
4024 ELKHART RD STE 23 |
| City | GOSHEN |
| State | IN |
| Zip Code | 46526-5803 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134631344 | Heidi Kauffmann | Social Worker | 2606 Peddler's Village Rd. Suite 210, Goshen, IN 46526 | 2017-10-27 |
| 1952812034 | Blue Diamond Villas | Skilled Nursing Facility | 1510 Sandpiper Lane, Goshen, IN 46526 | 2017-10-17 |
| 1578086534 | Anthony Escotto | Physical Therapist | 223 North Chicago Avenue, Goshen, IN 46526 | 2017-07-21 |
| 1831544774 | April Noelle Hart | Registered Nurse | 2606 Peddlers Village Rd., Suite 215, Goshen, IN 46526 | 2016-04-28 |
| 1639530108 | Amanda Miller | Physical Therapy Assistant | 114 Watertower Court, Goshen, IN 46526 | 2016-03-11 |
| 1720486095 | Gloria White | Pharmacist | 4430 Elkhart Road, C/o Walgreens, Goshen, IN 46526 | 2014-12-18 |
| 1184982472 | Dianna Christine Hoover | Occupational Therapist | 1627 Autumn Blaze Lane, Goshen, IN 46526 | 2012-04-24 |
| 1629361357 | Amy Rebecca Pointon | Nurse Practitioner | 1615 Winsted Dr Ste 1, Goshen, IN 46526 | 2011-05-27 |
| 1659670685 | Michiana Eye Center LLC | Optometrist | 1747 Stafford Ct, Goshen, IN 46526 | 2011-03-16 |
| 1467759001 | Natasha Candace Pontius | Occupational Therapy Assistant | 2400 College Aveune, Goshen, IN 46526 | 2011-02-17 |
| Find all providers in zip 46526 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629508825 | Derek A Radich | Optometrist | 1 Hatfield Ln Ste 3, Goshen, NY 10924-6753 | 2017-06-19 |
| 1659670685 | Michiana Eye Center LLC | Optometrist | 1747 Stafford Ct, Goshen, IN 46526 | 2011-03-16 |
| 1265669170 | Linda J. Clark, O.d. | Optometrist | 1765 Stafford Ct, Goshen, IN 46526-6542 | 2009-06-18 |
| 1538364906 | Reena Narula | Optometrist | 1 Hatfield Ln, Suite 3, Eye Physicians of Orange County, P.C., Goshen, NY 10924 | 2007-06-18 |
| 1013061803 | Linda Jean Clark | Optometrist | 1765 Stafford Court, Goshen, IN 46526-6542 | 2007-01-22 |
| 1689756066 | Paula Marie Ulmer | Optometrist | 176 Greenwich Ave, Goshen, NY 10924-2026 | 2006-10-19 |
| 1457336927 | Bryan Keith Stephens | Optometrist | 1722 Bashor Rd, Goshen, IN 46526-1302 | 2005-12-07 |
| 1710455126 | Angela Taylor | Optometrist | 116 W Washington St, Goshen, IN 46526-3729 | 2018-11-05 |
| 1164885042 | West Point Optical Group | Optometrist | 4024 Elkhart Rd, Suite 23, Goshen, IN 46526 | 2016-03-30 |
| 1689011413 | William Z King | Optometrist | 1615 Winsted Dr, Goshen, IN 46526-4696 | 2013-06-03 |
| Find all providers in GOSHEN | ||||
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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.