Active NPI
Dynamic Wound Care of Georgia, LLC
- General Practice Physician
- Jonesboro, GA
National Provider Identifier
1063385193
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- Legal business name
- DYNAMIC WOUND CARE OF GEORGIA, LLC
- Practice address
- 238 Stockbridge Rd Ste 104
Jonesboro, GA 30236-3629 - Phone
- (305) 901-5055
- NPI assigned
- Sep 25, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Kirill Filatov
- Title
- Cfo
- Phone
- (305) 901-5055
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | Primary |
Addresses
Primary practice location
238 Stockbridge Rd Ste 104
Jonesboro, GA 30236-3629
Mailing address
238 Stockbridge Rd Ste 104
Jonesboro, GA 30236-3629
Phone (305) 901-5055
National Provider Directory
National Provider DirectoryLocations
238 Stockbridge Rd
Ste 104
Jonesboro, GA 30236
Phone (305) 901-5055
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1758758400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1758758400000",
"number": "1063385193",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "238 STOCKBRIDGE RD STE 104",
"city": "JONESBORO",
"state": "GA",
"postal_code": "302363629",
"telephone_number": "305-901-5055"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "238 STOCKBRIDGE RD STE 104",
"city": "JONESBORO",
"state": "GA",
"postal_code": "302363629",
"telephone_number": "305-901-5055"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DYNAMIC WOUND CARE OF GEORGIA, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2025-09-25",
"last_updated": "2025-09-25",
"certification_date": "2025-09-25",
"status": "A",
"authorized_official_last_name": "FILATOV",
"authorized_official_first_name": "KIRILL",
"authorized_official_title_or_position": "CFO",
"authorized_official_telephone_number": "305-901-5055"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "General Practice",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Jonesboro, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.