Organization Active NPI

Complex Wound Solutions, LLC

  • Family Nurse Practitioner
  • Casper, WY
National Provider Identifier
1104644228
Registry record updated Sep 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
COMPLEX WOUND SOLUTIONS, LLC
Practice address
5830 E 2ND St Ste 7000
#18531
Casper, WY 82609-4308
Phone
(469) 733-0038
NPI assigned
Sep 27, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2024

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

Authorized official

Name
Lonnette M Alexander
Title
Owner
Phone
(469) 733-0038

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

5830 E 2ND St Ste 7000
#18531
Casper, WY 82609-4308

Mailing address

610 Crownpoint LN
Arlington, TX 76002-4776
Phone (469) 733-0038

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250206001793 TX Part B Supplier - Clinic/Group Practice 8325578388 Receives reassigned benefits from 7 practitioners
Practice locations: Arlington, TX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

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

NPI Registry JSON

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

{
    "created_epoch": "1727395200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727654400000",
    "number": "1104644228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 CROWNPOINT LN",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760024776",
            "telephone_number": "469-733-0038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5830 E 2ND ST STE 7000",
            "address_2": "#18531",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826094308",
            "telephone_number": "469-733-0038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPLEX WOUND SOLUTIONS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-27",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A",
        "authorized_official_last_name": "ALEXANDER",
        "authorized_official_first_name": "LONNETTE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "469-733-0038"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Casper, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 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.