NPIMap

Organization Active NPI

Woundynamics LLC

  • Family Medicine Physician
  • Oklahoma City, OK
National Provider Identifier
1114535333
Registry record updated Oct 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
WOUNDYNAMICS LLC
Practice address
1601 SW 89TH St Ste A100
Oklahoma City, OK 73159-6357
Phone
(206) 465-4313
NPI assigned
Jul 14, 2020
Last updated
Oct 10, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2023

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

Authorized official

Name
Danh Pham, DONPI 1932426269
Title
DO
Phone
(405) 225-1122

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
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

1601 SW 89TH St Ste A100
Oklahoma City, OK 73159-6357

Mailing address

1601 SW 89TH St Ste A100
Oklahoma City, OK 73159-6357
Phone (206) 465-4313

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20200728000660 OK Part B Supplier - Clinic/Group Practice 7719301449 Receives reassigned benefits from 11 practitioners
Practice locations: Oklahoma City, OK
O20220427002886 OK DME Supplier - Physician - General Practice 7719301449 Practice locations: Oklahoma City, OK

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 11

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": "1594684800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696896000000",
    "number": "1114535333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 SW 89TH ST STE A100",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731596357",
            "telephone_number": "206-465-4313",
            "fax_number": "405-225-1593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 SW 89TH ST STE A100",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731596357",
            "telephone_number": "206-465-4313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOUNDYNAMICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-14",
        "last_updated": "2023-10-10",
        "certification_date": "2023-10-10",
        "status": "A",
        "authorized_official_last_name": "PHAM",
        "authorized_official_first_name": "DANH",
        "authorized_official_title_or_position": "DO",
        "authorized_official_telephone_number": "405-225-1122",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2023; 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.