Advanced Wound Care Solutions LLC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

56746-20 Issued in WI

Legal business name

ADVANCED WOUND CARE SOLUTIONS LLC

Doing business as

Advanced Wound Care Solutions LLC

Practice address

10101 W Wisconsin Ave
Wauwatosa, WI 53226-4861

Phone

(314) 560-7057

NPI assigned

Apr 9, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Radhakrishna Janardhan, MDNPI 1871758029

Title

Ceo/Manager

Phone

(314) 560-7057

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Advanced Wound Care Solutions LLC Doing business as

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/17740/brand/1/csg/1/fhir/r4

Practitioners 2

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.

• Radhakrishna Janardhan, M.D

  • Surgery Physician
  • Madison, WI
  • NPI 1871758029
  Medicare reassignment NPD Authorized official
• Lindsey Noelle Terning, NP

  • Family Nurse Practitioner
  • Lake Villa, IL
  • NPI 1700383338

  WI

  Medicare reassignment NPD

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

{
    "created_epoch": "1523232000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1523232000000",
    "number": "1063919934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 S BEDFORD ST STE 1",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537033691",
            "telephone_number": "314-560-7057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10101 W WISCONSIN AVE",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532264861",
            "telephone_number": "314-560-7057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED WOUND CARE SOLUTIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-09",
        "last_updated": "2018-04-09",
        "status": "A",
        "authorized_official_last_name": "JANARDHAN",
        "authorized_official_first_name": "RADHAKRISHNA",
        "authorized_official_title_or_position": "CEO/MANAGER",
        "authorized_official_telephone_number": "314-560-7057",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "WI",
            "license": "56746-20",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100021975",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Wound Care Solutions LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Surgery Physician in Wauwatosa, WI
• Providers in Wauwatosa, WI by specialty
• Surgery Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2018; 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.