DR. KIMBERLY MOODY WADE (NPI# 1245533975) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245533975 |
| Entity Type | Individual |
| Full Name | DR. KIMBERLY MOODY WADE |
| Credential | D.M.D. |
| Practice Address |
3502 W Northside Dr Jackson MS 39213-4454 |
| Practice Telephone | 6013625321 |
| Mailing Telephone | 6013625321 |
| Enumeration Date | 2010-12-20 |
| Last Update Date | 2010-12-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
3578-10 | MS | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487019261 | Kimberly Wade | Licensed Practical Nurse | 737 Robinson St, Elmira, NY 14904-1538 | 2015-12-22 |
| 1225417637 | Kimberly Marie Wade | Speech-Language Pathologist | 9879 Kittywood Dr, Cincinnati, OH 45252-2151 | 2015-05-19 |
| 1972088771 | Kimberly Wade | Physical Therapy Assistant | 625 Walnut St, Mckeesport, PA 15132-2806 | 2018-09-27 |
| 1184143067 | Kimberly Wade | Behavior Technician | 41521 W 11 Mile Rd, Novi, MI 48375-1803 | 2017-09-12 |
| 1578946729 | Kimberly C Wade | Nurse Practitioner | 744 Airport Rd, Kinston, NC 28504-8800 | 2015-07-07 |
| 1184950925 | Kimberly Marie Wade | Nurse Anesthetist, Certified Registered | 1 Atwell Rd, Cooperstown, NY 13326-1301 | 2009-10-29 |
| Street Address |
3502 W NORTHSIDE DR |
| City | JACKSON |
| State | MS |
| Zip Code | 39213-4454 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952386559 | Laboratory Corporation of America Holdings | Clinical Medical Laboratory | 3502 W Northside Dr, Jackson, MS 39213-4454 | 2005-12-07 |
| 1689217812 | Ebony Martin | Case Manager/Care Coordinator | 3502 W Northside Dr, Jackson, MS 39213-4454 | 2019-10-21 |
| 1275189938 | April Terrain Perry | Nurse Practitioner | 3502 W Northside Dr, Jackson, MS 39213 | 2019-08-16 |
| 1013473891 | Ericia Latrice Cannon | Nurse Practitioner | 3502 W Northside Dr, Jackson, MS 39213-4454 | 2019-02-16 |
| 1578037172 | Jennifer Henley | Internal Medicine | 3502 W Northside Dr, Jackson, MS 39213-4454 | 2019-01-16 |
| 1003388968 | Tiffani Ricchele Mcknight | Social Worker | 3502 W Northside Dr, Jackson, MS 39213-4454 | 2018-12-17 |
| 1356810360 | Thrishanna Clark | Nurse Practitioner | 3502 W Northside Dr, Jackson, MS 39213-4454 | 2018-11-19 |
| 1376034660 | Sirna Musa | Nurse Practitioner | 3502 W Northside Dr, Jackson, MS 39213-4454 | 2018-05-23 |
| 1033649058 | Central Mississippi Civic Improvement Association, Inc. | Clinic/Center | 3502 W Northside Dr, Jackson, MS 39213-4454 | 2017-06-13 |
| 1013451780 | Katrice Pacley Andrews | Nurse Practitioner | 3502 W Northside Dr, Jackson, MS 39213-4454 | 2016-12-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679117980 | Cynthia Bailey | Technician | 916 Carnation Street, Jackson, MS 39213 | 2019-10-30 |
| 1871136374 | Shirley Collins Williams | Technician | 3132 Sage St, Jackson, MS 39213 | 2019-10-28 |
| 1275057069 | Nikita Patel | Pharmacist | 830 West Woodrow Wilson Avenue, Jackson, MS 39213 | 2017-08-02 |
| 1346782893 | Mississippi Smiles Dentistry LLC | Dentist | 310 W Woodrow Wilson Ave, 400, Jackson, MS 39213 | 2016-11-15 |
| 1730637521 | Ms Eyecare Associates of Jackson, Pllc. | Optometrist | 310 West Woodrow Wilson Avenue Suite 300, Jackson, MS 39213 | 2016-09-21 |
| 1518410778 | Assurance Home Health Services, LLC | Health Maintenance Organization | 1771 Hamilton Blvd., Jackson, MS 39213 | 2016-07-25 |
| 1831576180 | Dorothy Jeffries Anderson | Counselor | 350 Woodrow Wilson Ave, Jackson, MS 39213 | 2015-05-06 |
| 1740697275 | Sincere Home Care LLC. | Chore Provider | 5911 Holmes Ct, Jackson, MS 39213 | 2014-07-16 |
| 1629401088 | Deborah Diane Wright | Assisted Living Facility | 5911 Holmes Court, Jackson, MS 39213 | 2013-08-20 |
| 1245663251 | Methodist Home Road Living Center | Licensed Practical Nurse | 4560 Methodist Home Road, Jackson, MS 39213 | 2013-08-13 |
| Find all providers in zip 39213 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518584952 | Katherine Olivia Hughes | Dentist | 1189 Vann Dr, Jackson, TN 38305-6098 | 2020-07-01 |
| 1144845991 | Gregory Derrick Meredith | Dentist | 190 Water St Ste 2, Jackson, OH 45640-1384 | 2020-06-08 |
| 1033771852 | Robert E Scheddin | Dentist | 2046 W County Line Rd Ste 2, Jackson, NJ 08527-2034 | 2019-07-01 |
| 1649839291 | Andrew Harris | Dentist | 4505 I-55 Frontage Rd. N, Jackson, MS 39206 | 2019-06-07 |
| 1780145912 | Dr Lashawn Steptoe Family Dentistry | Dentist | 500 E Woodrow Wilson Ave Ste N, Jackson, MS 39216-4538 | 2019-03-29 |
| 1720571334 | Christina Holy Mcrae | Dentist | 3000 Old Canton Rd Ste 515, Jackson, MS 39216-4235 | 2018-06-08 |
| 1275024192 | Brianne Elizabeth Mezo | Dentist | 1500 W Parnall Rd, Jackson, MI 49201-8660 | 2018-05-26 |
| 1407343254 | West Tennessee Dentistry Pllc | Dentist | 1108 Whitehall St, Jackson, TN 38301-3730 | 2018-04-17 |
| 1073014338 | Helping Hands of Middle & West Tennessee | Dentist | 1408 N Highland Ave Ste 101, Jackson, TN 38301-3450 | 2018-02-22 |
| 1942730429 | Patrice Nicole Griffith | Dentist | 1189 E County Line Rd Ste 1010, Jackson, MS 39211-1836 | 2017-06-15 |
| Find all providers in JACKSON | ||||
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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.