NPIMap

Organization Active NPI

Mobile Wound Care Services - Southeast PC

  • Specialist
  • Mount Juliet, TN
National Provider Identifier
1134914518
Registry record updated Apr 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
MOBILE WOUND CARE SERVICES - SOUTHEAST PC
Practice address
2099 N Mount Juliet Rd Ste 7
Mount Juliet, TN 37122-3386
Phone
(919) 429-1901
NPI assigned
Apr 14, 2025
Last updated
Apr 15, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2025

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

Authorized official

Name
April Evans
Title
Director of Billing
Phone
(919) 429-1901

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X NU Primary

Addresses

Primary practice location

2099 N Mount Juliet Rd Ste 7
Mount Juliet, TN 37122-3386

Mailing address

4020 Progressive Church Rd
Princeton, NC 27569-8621
Phone (919) 429-1901

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, TX, SC, WV, NC5 enrollments

Enrollment records 5

Enrollment IDStateProvider typePAC IDDetails
O20250822002415 TN Part B Supplier - Clinic/Group Practice 1355841412 Receives reassigned benefits from 15 practitioners
Practice locations: Mount Juliet, TN
O20250920000368 TX Part B Supplier - Clinic/Group Practice 1355841412 Receives reassigned benefits from 3 practitioners
Practice locations: Mesquite, TX
O20251105002295 SC Part B Supplier - Clinic/Group Practice 1355841412 Receives reassigned benefits from 2 practitioners
Practice locations: Mount Pleasant, SC
O20251107002072 WV Part B Supplier - Clinic/Group Practice 1355841412 Receives reassigned benefits from 3 practitioners
Practice locations: Barboursville, WV
O20260217001706 NC Part B Supplier - Clinic/Group Practice 1355841412 Receives reassigned benefits from 3 practitioners
Practice locations: Princeton, NC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 27

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.

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1744588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744675200000",
    "number": "1134914518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4020 PROGRESSIVE CHURCH RD",
            "city": "PRINCETON",
            "state": "NC",
            "postal_code": "275698621",
            "telephone_number": "919-429-1901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2099 N MOUNT JULIET RD STE 7",
            "city": "MOUNT JULIET",
            "state": "TN",
            "postal_code": "371223386",
            "telephone_number": "919-429-1901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOBILE WOUND CARE SERVICES - SOUTHEAST PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-14",
        "last_updated": "2025-04-15",
        "certification_date": "2025-04-15",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "APRIL",
        "authorized_official_title_or_position": "DIRECTOR OF BILLING",
        "authorized_official_telephone_number": "919-429-1901"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Juliet, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2025; 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.