Wiregrass Wound Care Consultants LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

29664 Issued in AL

Legal business name

WIREGRASS WOUND CARE CONSULTANTS LLC

Practice address

1908 Fairview Ave
Dothan, AL 36301-3008

Phone

(251) 295-2815

Fax

(251) 295-2815

NPI assigned

Nov 2, 2013

Last updated

Dec 9, 2013By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Jeffrey Herbert Fadil, MDNPI 1467529495

Title

Physician

Phone

(251) 295-2815

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jeffrey H. Fadil, M.D.

  • Internal Medicine Physician
  • Abbeville, AL
  • NPI 1467529495
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1383350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386547200000",
    "number": "1003245838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 N HIGHWAY A1A",
            "address_2": "SUITE C112-113",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334774571",
            "telephone_number": "561-578-8407",
            "fax_number": "561-578-8099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1908 FAIRVIEW AVE",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363013008",
            "telephone_number": "251-295-2815",
            "fax_number": "251-295-2815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WIREGRASS WOUND CARE CONSULTANTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-02",
        "last_updated": "2013-12-09",
        "status": "A",
        "authorized_official_last_name": "FADIL",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "HERBERT",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "251-295-2815",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AL",
            "license": "29664",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wiregrass Urology, PC
• Wiregrass Vascular, P.C.
• Wiregrass Wellness Center, LLC
• Wiregrass Wound & Amputation Prevention Center, LLC
• Wiregrass Wound & Amputation Prevention Center, LLC
• Wiregrass Wound Care LLC
• Wirewall Healthcare Distribution LLC
• Jerry Paul Wisdom III, CRNP
• Jessica Nicole Wisdom, CRNP
• Steven Dwayne Wise, M.D.

• Internal Medicine Physician in Dothan, AL
• Providers in Dothan, AL by specialty
• Internal Medicine Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.