MRS. CRYSTAL ANN WADE (MSN, AG-ACNP-BC) – Adult Health Nurse Practitioner, NPI 1073173142
Adult Health Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
24,232 NURSE PRACTITIONER in FL
Provider Addresses for MRS. CRYSTAL ANN WADE (MSN, AG-ACNP-BC)
PO BOX 370
FORTSON, GA 318080370
Phone:
Fax: (706) 494-3008
Type: Mailing
2277 EAGLE HARBOR PKWY
FLEMING ISLAND, FL 320037306
Phone: (757) 291-3876
Type: Location
2285 MARSH HAWK LN APT 13102
FLEMING ISLAND, FL 320033309
Phone: (757) 291-3876
Type: Mailing
655 W. EIGHTH ST
ACC BUILDING 2ND FLOOR
JACKSONVILLE, FL 322093220
Phone: (904) 244-1010
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2019-08-07
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20190807001360 | I | Nurse Practitioner | FL | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 31808)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Certified Registered Nurse Anesthetist (Crna) | FL | |
| - | MN | |
| Physician Assistant | FL | |
| Diagnostic Radiology | FL | |
| Internal Medicine | FL | |
| - | FL | |
| Clinical Psychologist | FL | |
| U R O L O G Y | FL | |
| - | FL | |
| Nurse Practitioner | FL |
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