Organization Active NPI

Northwoods Mobile Wound Care, PLLC

  • Podiatrist
  • Appleton, WI
National Provider Identifier
1174494603
Registry record updated Sep 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
NORTHWOODS MOBILE WOUND CARE, PLLC
Practice address
2800 E Enterprise Ave Ste 333
Appleton, WI 54913-7889
Phone
(630) 687-0455
NPI assigned
Sep 17, 2025
Last updated
Sep 17, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2025

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

Authorized official

Name
Robert Burdi, DPMNPI 1255838975
Title
Owner
Phone
(630) 687-0455

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
Podiatrist 213E00000X NU Primary

Addresses

Primary practice location

2800 E Enterprise Ave Ste 333
Appleton, WI 54913-7889

Mailing address

714 Jonquil Ter
Deerfield, IL 60015-4247
Phone (630) 687-0455

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251017000457 WI Part B Supplier - Clinic/Group Practice 6608363106 Receives reassigned benefits from 1 practitioner
Practice locations: Appleton, WI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1758067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758067200000",
    "number": "1174494603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "714 JONQUIL TER",
            "city": "DEERFIELD",
            "state": "IL",
            "postal_code": "600154247",
            "telephone_number": "630-687-0455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 E ENTERPRISE AVE STE 333",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549137889",
            "telephone_number": "630-687-0455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWOODS MOBILE WOUND CARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-17",
        "last_updated": "2025-09-17",
        "certification_date": "2025-09-16",
        "status": "A",
        "authorized_official_last_name": "BURDI",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-687-0455",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Appleton, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 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.