Charleston Wound Care Center LLC

Primary specialty

Undersea and Hyperbaric Medicine (Emergency Medicine) PhysicianTaxonomy code 207PE0005X

Legal business name

CHARLESTON WOUND CARE CENTER LLC

Practice address

180 Wingo Way Ste 101
Mount Pleasant, SC 29464-1810

Phone

(843) 800-1215

Fax

(843) 284-9860

NPI assigned

May 15, 2018

Last updated

Mar 20, 2024By 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. Christopher M. Michaelis, DONPI 1174715809

Title

Owner

Phone

(484) 788-1443

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SC2 enrollments

Enrollment records 2

Locations

Practitioners 6

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.

• Christopher Michael Michaelis, D.O.

  • Emergency Medicine Physician
  • Mount Pleasant, SC
  • NPI 1174715809
  Medicare reassignment Care Compare group NPD Authorized official
• William Stirling Harper, MD

  • Emergency Medicine Physician
  • North Charleston, SC
  • NPI 1245677244
  Medicare reassignment Care Compare group NPD
• Kari Ann Yocum, FNP

  • Family Nurse Practitioner
  • Mount Pleasant, SC
  • NPI 1508629049
  Medicare reassignment Care Compare group NPD
• Courtney Augusta Justice, PA-C

  • Medical Physician Assistant
  • Summerville, SC
  • NPI 1700547411
  Medicare reassignment Care Compare group
• Kayley Manini, PA-C

  • Physician Assistant
  • Mount Pleasant, SC
  • NPI 1225800402
  Medicare reassignment Care Compare group
• Yenney E Meza, M.D.

  • Emergency Medicine Physician
  • Myrtle Beach, SC
  • NPI 1225241854
  Medicare reassignment NPD

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

{
    "created_epoch": "1526342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710892800000",
    "number": "1093205171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 WINGO WAY STE 101",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294641810",
            "telephone_number": "843-800-1215",
            "fax_number": "843-284-9860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 WINGO WAY STE 101",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294641810",
            "telephone_number": "843-800-1215",
            "fax_number": "843-284-9860"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1229 Nexton Pkwy Unit A",
            "address_purpose": "LOCATION",
            "city": "Summerville",
            "state": "SC",
            "postal_code": "294862167",
            "country_code": "US",
            "telephone_number": "843-585-3577",
            "fax_number": "843-585-3578",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CHARLESTON WOUND CARE CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-15",
        "last_updated": "2024-03-20",
        "certification_date": "2024-03-20",
        "status": "A",
        "authorized_official_last_name": "MICHAELIS",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "484-788-1443",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207PE0005X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Emergency Medicine, Undersea and Hyperbaric Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Undersea and Hyperbaric Medicine (Emergency Medicine) Physician in Mount Pleasant, SC
• Providers in Mount Pleasant, SC by specialty
• Undersea and Hyperbaric Medicine (Emergency Medicine) Physician in South Carolina

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