Wound Kinetics L L C

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

Legal business name

WOUND KINETICS L L C

Practice address

1240 Westlawn Dr
Kankakee, IL 60901-4657

Phone

(616) 359-2528

NPI assigned

Jul 16, 2024

Organization subpart

No

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

Authorized official

Name

Jamie Iedema

Title

Coo

Phone

(616) 359-2528

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL, MI, TX3 enrollments

Enrollment records 3

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Phillip Michael O'Connor, M.D.

  • General Practice Physician
  • Kankakee, IL
  • NPI 1659759652
  Medicare reassignment Care Compare group
• Scott Freland Thames Jr., M.D.

  • Emergency Medicine Physician
  • New Orleans, LA
  • NPI 1043573207

  MI, TX

  Medicare reassignment Care Compare group
• Yahaira Goffi, APRN-CNP

  • Family Nurse Practitioner
  • Tomball, TX
  • NPI 1235832007
  Medicare reassignment NPD
• Ryan Anthony Wiersma, FNP-C

  • Family Nurse Practitioner
  • Jenison, MI
  • NPI 1538882048

  Single Specialty

  Medicare reassignment NPD
• Elizabeth Dorothea Hooley, PHYSICIAN ASSISTANT

  • Physician Assistant
  • Kalamazoo, MI
  • NPI 1861728834
  Medicare reassignment

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

{
    "created_epoch": "1721088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724112000000",
    "number": "1013755909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4485 SILAS DR",
            "city": "DORR",
            "state": "MI",
            "postal_code": "493238003",
            "telephone_number": "616-359-2529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1240 WESTLAWN DR",
            "city": "KANKAKEE",
            "state": "IL",
            "postal_code": "609014657",
            "telephone_number": "616-359-2528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOUND KINETICS L L C",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-16",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-20",
        "status": "A",
        "authorized_official_last_name": "IEDEMA",
        "authorized_official_first_name": "JAMIE",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "616-359-2528"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gretchen Kathleen Williams, D.O
• Karen A Williams, MOTR/L
• Jennifer Windley
• Ashley Nicole Winterrowd, DPT
• Megan Winterrowd
• Christine Ann Woytek, OTR/L
• Allison Lanier Wright, CPHT
• Deborah Wright, RN
• Jeremy R Wright, FNP-BC
• Sarah Elizabeth Wroblewski, LCSW

• Physical Medicine & Rehabilitation Physician in Kankakee, IL
• Providers in Kankakee, IL by specialty
• Physical Medicine & Rehabilitation Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2024; 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.