NPIMap

Organization Active NPI

Southeast Wound Specialists, LLC

  • Emergency Medicine Physician
  • Charleston, SC
National Provider Identifier
1114953742
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
SOUTHEAST WOUND SPECIALISTS, LLC
Practice address
9302 Medial Plaza Drive
Suite a
Charleston, SC 29406-9142
Phone
(912) 232-9700
Fax
(912) 748-0270
NPI assigned
Jun 24, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Timothy J. Gregory, M.D.NPI 1073556452
Title
Owner
Phone
(912) 232-9700

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X NU Primary
Undersea and Hyperbaric Medicine (Emergency Medicine) Physician 207PE0005X NU

Addresses

Primary practice location

9302 Medial Plaza Drive
Suite a
Charleston, SC 29406-9142

Mailing address

PO Box 1345
Savannah, GA 31402-1345
Phone (912) 232-9700

Other identifiers 2

IdentifierTypeStateIssuer
GP4454MedicaidSC
013997MedicaidGA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1151107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1114953742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1345",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314021345",
            "telephone_number": "912-232-9700",
            "fax_number": "912-748-0270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9302 MEDIAL PLAZA DRIVE",
            "address_2": "SUITE A",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294069142",
            "telephone_number": "912-232-9700",
            "fax_number": "912-748-0270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST WOUND SPECIALISTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-24",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "GREGORY",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "912-232-9700",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207PE0005X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Undersea and Hyperbaric Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP4454",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "013997",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.