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BRYON KEITH WADE JR.
NPI 1104794973
Peer Specialist in Pryor, OK

Active since October 24, 2025
109 N FAIRLAND ST, PRYOR, OK 74361(918) 625-6128 Get Directions Write a Review

NPPES record last updated: October 24, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Bryon Keith Wade Jr. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BRYON KEITH WADE JR. (NPI 1104794973) is an individual peer specialist in Pryor, Oklahoma and active in the NPI registry since October 2025.

NPPES Registry Identity

NPI1104794973
Entity TypeIndividualMale
Primary Taxonomy175T00000X
Provider Legal NameBRYON KEITH WADE JR.
Location Address109 N FAIRLAND STPryor, OK 74361-4205
Mailing Address109 N Fairland StPryor, OK 74361-4205 · (580) 768-1927
Phone(918) 625-6128
Sole ProprietorYes
Enumeration DateOctober 24, 2025
NPPES CertifiedOctober 24, 2025
✔ NPI 1104794973 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPeer SpecialistOther Service Providers
Taxonomy Code175T00000X
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
109 N FAIRLAND ST, Pryor, OK 74361
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KALI ROSE KERNS
Peer Specialist
109 N FAIRLAND ST
PRYOR, OK 74361
Mayes County (918) 825-1405
JACKIE ELAINE HORTON
Case Manager/Care Coordinator
109 N FAIRLAND ST
PRYOR, OK 74361
Mayes County (918) 825-1405
WHITNEY JOANNA PHILLIPS
Peer Specialist
109 N FAIRLAND ST
PRYOR, OK 74361
Mayes County (918) 825-1405
BREANNA NICOLE COOK MHR, LPC-C
Counselor (Mental Health)
109 N FAIRLAND ST
PRYOR, OK 74361
Mayes County (918) 825-1401
NICOLE BURNHAM LPN
Licensed Practical Nurse
109 N FAIRLAND ST
PRYOR, OK 74361
Mayes County (918) 825-1405
STEPHANIE RENEE STACY
Peer Specialist
109 N FAIRLAND ST
PRYOR, OK 74361
Mayes County (918) 273-1841
CRYSTAL MICHELLE CUMMINS
Case Manager/Care Coordinator
109 N FAIRLAND ST
PRYOR, OK 74361
Mayes County (918) 825-1405
KANDICE BRIANS
Peer Specialist
109 N FAIRLAND ST
PRYOR, OK 74361
Mayes County (918) 273-1841

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Bryon Wade's NPI number?

The NPI number for Bryon Wade is 1104794973. It was assigned to this individual provider in the NPPES registry on October 24, 2025.

Where is Bryon Wade located?

Bryon Wade practices at 109 N Fairland St, Pryor, OK 74361. The listed phone number is (918) 625-6128.

What is Bryon Wade's specialty?

The primary specialty registered for this NPI is Peer Specialist with taxonomy code 175T00000X.

When was this NPI record last updated?

The NPPES record for Bryon Wade was last updated on October 24, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.