Elite Wound Care LLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

ELITE WOUND CARE LLC

Practice address

1365 Flowering Dogwood LN Ste F
Dyersburg, TN 38024-2884

Phone

(731) 777-9797

NPI assigned

Oct 4, 2024

Organization subpart

No

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

Authorized official

Name

Sydni Clemmons

Title

Credentialing

Phone

(901) 351-1791

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1728000000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728000000000",
    "number": "1295554400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1365 FLOWERING DOGWOOD LN STE F",
            "city": "DYERSBURG",
            "state": "TN",
            "postal_code": "380242884",
            "telephone_number": "731-777-9797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1365 FLOWERING DOGWOOD LN STE F",
            "city": "DYERSBURG",
            "state": "TN",
            "postal_code": "380242884",
            "telephone_number": "731-777-9797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE WOUND CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-04",
        "last_updated": "2024-10-04",
        "certification_date": "2024-10-04",
        "status": "A",
        "authorized_official_last_name": "CLEMMONS",
        "authorized_official_first_name": "SYDNI",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "901-351-1791"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Physician in Dyersburg, TN
• Providers in Dyersburg, TN by specialty
• General Practice Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 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.