Organization Active NPI

Healistic Wound Care Management Group

  • Family Nurse Practitioner
  • Florence, SC
National Provider Identifier
1205625985
Registry record updated May 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
HEALISTIC WOUND CARE MANAGEMENT GROUP
Practice address
2724 W Palmetto St Ste 12
Florence, SC 29501-4909
Phone
(843) 992-2754
NPI assigned
May 1, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2025

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

Authorized official

Name
Hillery DolfordNPI 1104283548
Title
Owner
Phone
(843) 992-2754

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QG0300X
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

2724 W Palmetto St Ste 12
Florence, SC 29501-4909

Mailing address

2724 W Palmetto St Ste 12
Florence, SC 29501-4909
Phone (843) 992-2754

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251021003909 SC Part B Supplier - Clinic/Group Practice 9032607155 Receives reassigned benefits from 1 practitioner
Practice locations: Florence, SC

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.

NPI Registry JSON

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

{
    "created_epoch": "1746057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746057600000",
    "number": "1205625985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2724 W PALMETTO ST STE 12",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295014909",
            "telephone_number": "843-992-2754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2724 W PALMETTO ST STE 12",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295014909",
            "telephone_number": "843-992-2754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALISTIC WOUND CARE MANAGEMENT GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-01",
        "last_updated": "2025-05-01",
        "certification_date": "2025-05-01",
        "status": "A",
        "authorized_official_last_name": "DOLFORD",
        "authorized_official_first_name": "HILLERY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-992-2754"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Florence, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 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.