Organization Active NPI

Prime Advanced Wound Care Group

  • Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
  • Arlington, TX
National Provider Identifier
1114851888
Registry record updated Aug 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Undersea and Hyperbaric Medicine (Preventive Medicine) PhysicianTaxonomy code 2083P0011X
Legal business name
PRIME ADVANCED WOUND CARE GROUP
Practice address
4201 Interway PL
Arlington, TX 76018-5668
Phone
(888) 777-9032
NPI assigned
Jun 9, 2026
Last updated
Aug 4, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2026

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

Authorized official

Name
Janelle Kelley
Title
Member
Phone
(903) 647-7580

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Undersea and Hyperbaric Medicine (Preventive Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2083P0011X Primary
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X

Addresses

Primary practice location

4201 Interway PL
Arlington, TX 76018-5668

Mailing address

4201 Interway PL
Arlington, TX 76018-5668

Other practice location 1

1512 Teasley Ln
Denton, TX 76205-7282
Phone (888) 777-9032

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1780963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785801600000",
    "number": "1114851888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 INTERWAY PL",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760185668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 INTERWAY PL",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760185668",
            "telephone_number": "888-777-9032"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1512 Teasley Ln",
            "address_purpose": "LOCATION",
            "city": "Denton",
            "state": "TX",
            "postal_code": "762057282",
            "country_code": "US",
            "telephone_number": "888-777-9032",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PRIME ADVANCED WOUND CARE GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-06-09",
        "last_updated": "2026-08-04",
        "certification_date": "2026-08-04",
        "status": "A",
        "authorized_official_last_name": "KELLEY",
        "authorized_official_first_name": "JANELLE",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "903-647-7580"
    },
    "taxonomies": [
        {
            "code": "2083P0011X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Preventive Medicine, Undersea and Hyperbaric Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.