Organization Active NPI

Enhanced Wound Care LLC

  • Point of Service
  • Overland Park, KS
National Provider Identifier
1306528864
Registry record updated Jul 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Point of ServiceTaxonomy code 305S00000X
Legal business name
ENHANCED WOUND CARE LLC
Practice address
9393 W 110TH St Ste 527
Overland Park, KS 66210-1442
Phone
(918) 231-8724
NPI assigned
Aug 3, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2025

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

Authorized official

Name
Andrea Holley
Title
Ceo
Phone
(918) 231-8724

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Point of Service 305S00000X Primary

Addresses

Primary practice location

9393 W 110TH St Ste 527
Overland Park, KS 66210-1442

Mailing address

6440 Avondale Dr Ste 202
Nichols Hills, OK 73116-6416
Phone (918) 231-8724

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS, MO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20230821003510 KS Part B Supplier - Clinic/Group Practice 2769877000 Receives reassigned benefits from 5 practitioners
Practice locations: Overland Park, KS
O20231019001355 MO Part B Supplier - Clinic/Group Practice 2769877000 Receives reassigned benefits from 5 practitioners
Practice locations: Weston, MO

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Locations

9393 W 110th St
Ste 527
Overland Park, KS 66210
Phone (918) 231-8724

6440 Avondale Dr
Nichols Hills, OK 73116

6440 Avondale Dr
Ste 200
Nichols Hills, OK 73116
Phone (405) 409-5742

Practitioners & affiliated clinicians

Practitioners 9

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": "1691020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753401600000",
    "number": "1306528864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6440 AVONDALE DR STE 202",
            "city": "NICHOLS HILLS",
            "state": "OK",
            "postal_code": "731166416",
            "telephone_number": "918-231-8724",
            "fax_number": "918-512-4063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9393 W 110TH ST STE 527",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662101442",
            "telephone_number": "918-231-8724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENHANCED WOUND CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-03",
        "last_updated": "2025-07-25",
        "certification_date": "2025-07-25",
        "status": "A",
        "authorized_official_last_name": "HOLLEY",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "918-231-8724"
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Overland Park, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 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.