Louisville Wound Care Associates PSC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

18435 Issued in KY

Legal business name

LOUISVILLE WOUND CARE ASSOCIATES PSC

Practice address

1 Audubon Plaza Dr
Louisville, KY 40217

Phone

(502) 777-9961

Fax

(502) 379-8791

NPI assigned

Aug 7, 2006

Organization subpart

No

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

Authorized official

Name

Rodney D McMillin, MDNPI 1467454637

Title

President

Phone

(502) 777-9961

Specialties & licenses 3

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

Locations

Practitioners 3

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

• Rodney D McMillin, M.D.

  • Surgery Physician
  • Louisville, KY
  • NPI 1467454637
  Medicare reassignment Care Compare group NPD Authorized official
• Bryce E Schuster, M.D.

  • Surgery Physician
  • Louisville, KY
  • NPI 1588668818
  Medicare reassignment Care Compare group
• Joseph Marion Blandford Jr., M.D.

  • Surgery Physician
  • Louisville, KY
  • NPI 1124020300
  NPD (past)

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

{
    "created_epoch": "1154908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1526428800000",
    "number": "1124037114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 GARDINER LN STE 207",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402052948",
            "telephone_number": "502-777-9961",
            "fax_number": "502-379-8791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 AUDUBON PLAZA DR",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "40217",
            "telephone_number": "502-777-9961",
            "fax_number": "502-379-8791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOUISVILLE WOUND CARE ASSOCIATES PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-07",
        "last_updated": "2018-05-16",
        "status": "A",
        "authorized_official_last_name": "MCMILLIN",
        "authorized_official_first_name": "RODNEY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "502-777-9961",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "KY",
            "license": "23946",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "KY",
            "license": "18435",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "3003616",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201260300",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000486840",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65945933",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT",
            "identifier": "50012570",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "78905221",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Louisville Vamc
• Louisville Vamc
• Louisville Vamc
• Louisville Vascular Care LLC
• Louisville Veterans Hospital
• Louisville-Jefferson County Metro Government
• Louisville-Jefferson County Metro Government
• Louisville-Jefferson County Metro Government
• Louisville-Jefferson County Metro Government
• Louisville-Jefferson County Metro Government

• Surgery Physician in Louisville, KY
• Providers in Louisville, KY by specialty
• Surgery Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2018; 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.