Active NPI
Professional Wound Specialists PLLC
- Surgery Physician
- Sheridan, WY
National Provider Identifier
1245037712
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- Legal business name
- PROFESSIONAL WOUND SPECIALISTS PLLC
- Practice address
- 1309 Coffeen Ave Ste 1200
Sheridan, WY 82801-5777 - Phone
- (888) 434-8880
- Fax
- (855) 434-8880
- NPI assigned
- Mar 3, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Nikki Nguyen
- Title
- Office Manager
- Phone
- (888) 434-8880
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | Primary |
Addresses
Primary practice location
1309 Coffeen Ave Ste 1200
Sheridan, WY 82801-5777
Mailing address
1309 Coffeen Ave Ste 1200
Sheridan, WY 82801-5777
Phone (888) 434-8880
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20250314001997 | WY | Part B Supplier - Clinic/Group Practice | 8921533183 |
Receives reassigned benefits from 2 practitioners Practice locations: Sheridan, WY |
Other NPIs with the same Medicare PAC ID 3
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
National Provider Directory
National Provider Directory- Tax ID family
- Professional Wound Specialists PLLC
Other organizations with this tax ID 3
Organizations that report the same tax identification number in the National Provider Directory.
-
- Surgery Physician
- Albuquerque, NM
- NPI 1033933494
-
- Surgery Physician
- Denver, CO
- NPI 1124842588
-
- Surgery Physician
- Boise, ID
- NPI 1861216228
Practitioners & affiliated clinicians
Practitioners 2
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": "1740960000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1740960000000",
"number": "1245037712",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1309 COFFEEN AVE STE 1200",
"city": "SHERIDAN",
"state": "WY",
"postal_code": "828015777",
"telephone_number": "888-434-8880",
"fax_number": "855-434-8880"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1309 COFFEEN AVE STE 1200",
"city": "SHERIDAN",
"state": "WY",
"postal_code": "828015777",
"telephone_number": "888-434-8880",
"fax_number": "855-434-8880"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PROFESSIONAL WOUND SPECIALISTS PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2025-03-03",
"last_updated": "2025-03-03",
"certification_date": "2025-03-02",
"status": "A",
"authorized_official_last_name": "NGUYEN",
"authorized_official_first_name": "NIKKI",
"authorized_official_title_or_position": "OFFICE MANAGER",
"authorized_official_telephone_number": "888-434-8880"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Surgery",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sheridan, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 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.