Organization Active NPI

HC Wound Management PSC

  • Internal Medicine Physician
  • Benton, KY
National Provider Identifier
1083571327
Registry record updated Jan 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
HC WOUND MANAGEMENT PSC
Practice address
2607 Main St
Benton, KY 42025-7601
Phone
(732) 631-4358
Fax
(732) 631-4353
NPI assigned
Jan 8, 2026
Last updated
Jan 8, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2026

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

Authorized official

Name
Daniel OliveroNPI 1902144512
Title
Owner
Phone
(732) 631-4358

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X Primary

Addresses

Primary practice location

2607 Main St
Benton, KY 42025-7601

Mailing address

15 America Ave Unit 103
Lakewood, NJ 08701-4583
Phone (732) 631-4358

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, TN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20260309000361 KY Part B Supplier - Clinic/Group Practice 1759864747 Receives reassigned benefits from 1 practitioner
Practice locations: Benton, KY
O20260522002900 TN Part B Supplier - Clinic/Group Practice 1759864747 Receives reassigned benefits from 1 practitioner
Practice locations: Kingsport, TN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1767830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1767830400000",
    "number": "1083571327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 AMERICA AVE UNIT 103",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087014583",
            "telephone_number": "732-631-4358",
            "fax_number": "732-631-4353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2607 MAIN ST",
            "city": "BENTON",
            "state": "KY",
            "postal_code": "420257601",
            "telephone_number": "732-631-4358",
            "fax_number": "732-631-4353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HC WOUND MANAGEMENT PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-01-08",
        "last_updated": "2026-01-08",
        "certification_date": "2026-01-08",
        "status": "A",
        "authorized_official_last_name": "OLIVERO",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-631-4358"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Benton, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2026; 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.