DR. MARK ALAN WADE (NPI# 1356307458) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356307458 |
| Entity Type | Individual |
| Full Name | DR. MARK ALAN WADE |
| Credential | MD |
| Practice Address |
2310 Peger Rd Ste 105 Fairbanks AK 99709-5315 |
| Practice Telephone | 9074792663 |
| Practice Fax Number | 9074792691 |
| Mailing Telephone | 9074792663 |
| Mailing Fax Number | 9074792691 |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2013-04-18 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207X00000X | Orthopaedic Surgery | 4018 | AK | Allopathic & Osteopathic Physicians |
| Y | 207XX0005X |
Orthopaedic Surgery Specialization: Sports Medicine |
4018 | AK | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AK | DEPT OF LABOR ID | 194028200 | 01 |
| AK | MD6149 | 05 | |
| AK | MD07391 | 05 | |
| AK | MD07392 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558569921 | Mark Robert Wade | Internal Medicine | 1 Hope Dr, Tustin, CA 92782-0221 | 2007-07-06 |
| 1972553410 | Mark W. Wade | Chiropractor | 295 N Broad St, Carlinville, IL 62626-1301 | 2006-05-12 |
| 1376512137 | Mark D. Wade | Optometrist | 12601 Olive Blvd, Saint Louis, MO 63141-6313 | 2006-03-15 |
| 1043769151 | Mark Wade | Physical Therapy Assistant | 2120 Highland Ave, Knoxville, TN 37916-1112 | 2016-09-30 |
| 1962782474 | Mark Wade | Pediatrics | 275 Hobart St, Perth Amboy, NJ 08861-3396 | 2011-08-29 |
| 1295929974 | Mark R Wade | Case Manager/Care Coordinator | 2151 College Ave, Bakersfield, CA 93305-4172 | 2007-09-05 |
| 1104964097 | Mark Harrison Wade | Counselor | 3169 2nd Ave E, Big Stone Gap, VA 24219 | 2007-02-02 |
| 1104814631 | Mark Wade | Optometrist | 2700 W College Ave, Appleton, WI 54914-2918 | 2005-10-10 |
| Street Address |
2310 PEGER RD STE 105 |
| City | FAIRBANKS |
| State | AK |
| Zip Code | 99709-5315 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285272260 | Anesthesia Consultants of Fairbanks LLC | Anesthesiology | 2310 Peger Rd, Fairbanks, AK 99709-5305 | 2019-12-20 |
| 1831642834 | Christopher Dean Burns | Nurse Anesthetist, Certified Registered | 2310 Peger Rd, Fairbanks, AK 99709-5305 | 2016-07-26 |
| 1467809699 | Angela Britt | Physician Assistant | 2310 Peger Rd, Fairbanks, AK 99709 | 2016-05-18 |
| 1306252036 | Kelsi Johnson | Physical Therapist | 2310 Peger Rd, Suite 101, Fairbanks, AK 99709-5315 | 2014-07-02 |
| 1952654139 | Spine Care Specialists of Alaska LLC | Neurological Surgery | 2310 Peger Rd, Ste 106, Fairbanks, AK 99709-5305 | 2012-10-24 |
| 1740571595 | Jason Douglas Gillam | Physical Therapist | 2310 Peger Rd, Suite 101, Fairbanks, AK 99709-5315 | 2011-04-28 |
| 1528360625 | Fairbanks Medical Imaging LLC | Radiology | 2310 Peger Rd, Suite 102, Fairbanks, AK 99709-5305 | 2010-11-22 |
| 1871758771 | Cassandra Cathleen Brice | Physical Therapist | 2310 Peger Rd, Suite 101, Fairbanks, AK 99709-5305 | 2008-07-21 |
| 1275574493 | Paul L Jensen | Neurological Surgery | 2310 Peger Rd, Ste 106, Fairbanks, AK 99709-5305 | 2006-06-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255946810 | Beacon Monitoring Professional Services | Technician, Other | 745 Staffordshire Rd, Fairbanks, AK 99709 | 2020-09-10 |
| 1235629544 | Fairbanks Healing Space | Health Educator | 3875 Geist Road, Suite E #136, Fairbanks, AK 99709 | 2018-05-11 |
| 1609395409 | Shawn K Goggins | Counselor | 1423 Peger Road, Fairbanks, AK 99709 | 2017-09-12 |
| 1710433347 | Jay Titus | Technician/Technologist | 2884 Marina Drive, Fairbanks, AK 99709 | 2016-09-01 |
| 1710391610 | Hannah Summerfelt | Dentist | 3539 Thomas St, Fairbanks, AK 99709 | 2014-06-18 |
| 1629407325 | Diane Louise Mitchell | Nurse Practitioner | 4650 Harvard Cir, Fairbanks, AK 99709 | 2013-11-04 |
| 1407147929 | Christina Martz | Counselor | 1270 Summet Drive, Fairbanks, AK 99709 | 2011-05-02 |
| 1255652285 | Surgery Center of Fairbanks LLC | Clinic/Center | 2310 Peger Road, Fairbanks, AK 99709 | 2010-06-14 |
| 1962661835 | John Leo Hughes Jr Jr. | Dentist | 3437 Airport Way, Suite 205, Fairbanks, AL 99709 | 2008-06-05 |
| 1508042417 | Katherine E Johnson, Md PC | Ophthalmology | 2485 Chief William Drive, Suite 100, Fairbanks, AK 99709 | 2008-01-10 |
| Find all providers in zip 99709 | ||||
| Taxonomy Code | 207XX0005X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Sports Medicine |
| An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton changed, source changed] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. ACGME Accredited Program Requirements: 1 year GME in the specialty + 5 years of Orthopaedic Surgery for a total of 6 years |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922127992 | Cary S Keller Md PC | Orthopaedic Surgery | 1919 Lathrop St, Suite 105, Fairbanks, AK 99701-5937 | 2007-03-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972535417 | Herbert O Bote | Orthopaedic Surgery | 289 N Fireweed St Ste B, Soldotna, AK 99669-7570 | 2006-07-07 |
| 1942840038 | Hci Ortho | Orthopaedic Surgery | 289 N Fireweed St Ste D, Soldotna, AK 99669-7570 | 2020-01-07 |
| 1285000497 | Hciortho | Orthopaedic Surgery | 289 N Fireweed St Ste B, Soldotna, AK 99669-7570 | 2015-08-11 |
| 1467502567 | Jeffrey S. Moore Md and Elisha T. Powell Iv Md LLC | Orthopaedic Surgery | 2751 Debarr Rd, Suite 310, Anchorage, AK 99508-2953 | 2007-01-11 |
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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.