Synergy Wound Care LLC

Primary specialty

Wound Care Registered NurseTaxonomy code 163WW0000X

Legal business name

SYNERGY WOUND CARE LLC

Practice address

22 Millbranch Rd Ste 200
Hattiesburg, MS 39402-1591

Phone

(256) 328-5041

NPI assigned

Apr 23, 2024

Organization subpart

No

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

Authorized official

Name

Tyler Stout

Title

Credentialing Manager

Phone

(337) 315-7927

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1713830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713830400000",
    "number": "1225883184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 MILLBRANCH RD STE 200",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394021591",
            "telephone_number": "256-328-5041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 MILLBRANCH RD STE 200",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394021591",
            "telephone_number": "256-328-5041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SYNERGY WOUND CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-23",
        "last_updated": "2024-04-23",
        "certification_date": "2024-04-23",
        "status": "A",
        "authorized_official_last_name": "STOUT",
        "authorized_official_first_name": "TYLER",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "337-315-7927"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163WW0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Wound Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Wound Care Registered Nurse in Hattiesburg, MS
• Providers in Hattiesburg, MS by specialty
• Wound Care Registered Nurse in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2024; 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.