MR. TY C. WADE (NPI# 1922145101) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922145101 |
| Entity Type | Individual |
| Full Name | MR. TY C. WADE |
| Credential | DC |
| Practice Address |
620 E. Green Bay Ave. Suite 104 Saukville WI 53080 |
| Practice Telephone | 2622840022 |
| Practice Fax Number | 2622680715 |
| Mailing Telephone | 2622840022 |
| Mailing Fax Number | 2622680715 |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2011-01-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | 4012-012 | WI | Chiropractic Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | WEA | 202500022 | 01 |
| WI | WPPN | 202500022 | 01 |
| WI | 38950300 | 05 | |
| WI | ACN | 649385 | 01 |
| WI | UHC | 202500022 | 01 |
| WI | 389-50300 | 05 |
| Street Address |
620 E. GREEN BAY AVE. SUITE 104 |
| City | SAUKVILLE |
| State | WI |
| Zip Code | 53080 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437757069 | Kerri Lynn Garant | Pharmacist | Walmart Pharmacy 10-1650, 825 E. Green Bay Avenue, Saukville, WI 53080 | 2020-10-15 |
| 1619527090 | Latisha Irene Metealf | Technician | 604 W Hillcrest Rd Apt 111, Saukville, WI 53080 | 2019-09-17 |
| 1578841854 | Calvin Donald Thomas | Physical Therapist | 516 East Green Bay Ave, Saukville, WI 53080 | 2011-08-03 |
| 1578681748 | Julie Schueller | Physical Therapist | 516 E. Green Bay Ave, Saukville, WI 53080 | 2007-03-27 |
| 1427116375 | Stuart W Natale | Optometrist | 289 E Green Bay Ave, Saukville, WI 53080 | 2006-12-04 |
| 1245520055 | Wal-mart Stores East Lp | Technician/Technologist | 825 E Green Bay Ave, Saukville, WI 53080 | 2011-04-13 |
| 1659590370 | Diane Mary Ott | Physical Therapist | 516 E Green Bay Ave, Saukville, WI 53080 | 2007-04-24 |
| 1902134224 | Knutson | Durable Medical Equipment & Medical Supplies | N5272 Highway I, Saukville, WI 53080-1040 | 2009-11-24 |
| 1962733790 | Nancy Evon Knutson | Licensed Practical Nurse | N5272 Highway I, Saukville, WI 53080-1040 | 2010-01-19 |
| 1275649790 | Ronald Paul Stifter | Dentist | 2659 Hawthorne Dr, Saukville, WI 53080-1109 | 2006-08-21 |
| Find all providers in zip 53080 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770722720 | Michael D Erickson | Chiropractor | 830 E Green Bay Avenue, Suite 103, Saukville, WI 53080-2662 | 2009-02-16 |
| 1104844430 | Kelly Joan Wolf | Chiropractor | 620 E Green Bay Ave, Ste 104, Saukville, WI 53080-2038 | 2006-07-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518567668 | Zachary Arnold Wickert | Chiropractor | N144w6220 Pioneer Rd, Cedarburg, WI 53012-2723 | 2020-10-28 |
| 1215537501 | Seek Chiropractic LLC | Chiropractor | 405 S Farwell St Ste 21, Eau Claire, WI 54701-2701 | 2020-10-27 |
| 1043819824 | Courtney Helen Slaby | Chiropractor | 559 Braund St Ste 3, Onalaska, WI 54650-8659 | 2020-10-22 |
| 1548869423 | Journey Chiropractic LLC | Chiropractor | 101 E Sadd St, North Prairie, WI 53153-9775 | 2020-10-21 |
| 1154929909 | Water City Care Mission, Inc. | Chiropractor | 449 High Ave., Oshkosh, WI 54901-4708 | 2020-10-14 |
| 1366049793 | Phoenix Chiropractic and Wellness, LLC | Chiropractor | 250 N Green Bay Rd Unit D, Neenah, WI 54956-2285 | 2020-10-08 |
| 1598371668 | Michael Allen Markowski | Chiropractor | 1632 N 18th St # 1, Manitowoc, WI 54220-1858 | 2020-09-23 |
| 1801408687 | Chiro One Wellness Center of Pleasant Prairie LLC | Chiropractor | 9755 76th St Ste 730, Pleasant Prairie, WI 53158-1925 | 2020-08-21 |
| 1972115186 | Shelby Chapelle | Chiropractor | 1711 Green Bay Rd Ste C, Kenosha, WI 53144-1209 | 2020-08-19 |
| 1659981801 | Reince Chiropractic LLC | Chiropractor | 13382 Velp Ave Ste A, Suamico, WI 54313-8191 | 2020-08-03 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on MR. TY C. WADE.
| 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.