1. Home
  2. Directory
  3. Utah
  4. Logan
  5. Physician Assistant
  6. NPI Profile

MR. KENNETH ALAN WADE P.A
NPI 1699826149
Physician Assistant - Medical in Logan, UT

Active since January 12, 2007PECOS Enrolled
1325 N 600 E, SUITE 102, LOGAN, UT 84341(435) 753-9999(435) 753-2301 Get Directions Write a Review

NPPES record last updated: November 29, 2016. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Mr. Kenneth Alan Wade P.a NPPES

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

MR. KENNETH ALAN WADE P.A (NPI 1699826149) is an individual medical provider in Logan, Utah, licensed in Utah (1015921206) and active in the NPI registry since January 2007. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1699826149
Entity TypeIndividualMale
Primary Taxonomy363AM0700X
Provider Legal NameMR. KENNETH ALAN WADECredential: P.A
Location Address1325 N 600 E, SUITE 102Logan, UT 84341-6738
Mailing Address1325 N 600 E, Suite 102Logan, UT 84341-6738 · (435) 753-9999 · Fax (435) 753-2301
Phone(435) 753-9999
Fax(435) 753-2301
Sole ProprietorNo
Enumeration DateJanuary 12, 2007
Last NPPES UpdateNovember 29, 2016
✔ NPI 1699826149 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License✔ Licensed in UT · 1015921206
1325 N 600 E, Logan, UT 84341
Open in Google Maps ↗

Other Identifiers 1

Other1015921206UT · State License

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Kenneth Alan Wade P.a is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 7

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

BARRY A NOORDA MD
Obstetrics & Gynecology
1325 N 600 E, 102
LOGAN, UT 84341
Cache County (435) 753-9999
GARY K FOWERS MD
Obstetrics & Gynecology
1325 N 600 E, STE 102
LOGAN, UT 84341
Cache County (435) 753-9999
MRS. ANNE SADLER BLACKETT DO
Obstetrics & Gynecology
1325 N 600 E, SUITE 102
LOGAN, UT 84341
Cache County (435) 753-9999
RYAN R BELL
Pediatrics
1325 N 600 E, SUITE 101
LOGAN, UT 84341
Cache County (435) 750-5599
MARCI KAE BUTTARS APRN
Nurse Practitioner (Family)
1325 N 600 E, SUITE 101
LOGAN, UT 84341
Cache County (435) 750-5599
AMY A BILLINGS PAC
Obstetrics & Gynecology
1325 N 600 E, SUITE 102
LOGAN, UT 84341
Cache County (435) 753-9999
BRUCE A O'VERY MD
Pediatrics
1325 N 600 E, STE 101
LOGAN, UT 84341
Cache County (435) 750-5599

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 Kenneth Wade's NPI number?

The NPI number for Kenneth Wade is 1699826149. It was assigned to this individual provider in the NPPES registry on January 12, 2007.

Where is Kenneth Wade located?

Kenneth Wade practices at 1325 N 600 E Suite 102, Logan, UT 84341. The listed phone number is (435) 753-9999.

What is Kenneth Wade's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is Kenneth Wade enrolled in Medicare?

Yes. Kenneth Wade is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Kenneth Wade was last updated on November 29, 2016. NPI Profile syncs with the weekly NPPES data releases published by CMS.