Organization Active NPI

Enhanced Wound Care LLC

  • Point of Service
  • Nichols Hills, OK
National Provider Identifier
1306594148
Registry record updated May 20, 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
6440 Avondale Dr Ste 202
Nichols Hills, OK 73116-6416
Phone
(918) 231-8724
Fax
(918) 512-4063
NPI assigned
Mar 11, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2025

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Point of Service 305S00000X Primary

Addresses

Primary practice location

6440 Avondale Dr Ste 202
Nichols Hills, OK 73116-6416

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 OK, TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20220726000190 OK Part B Supplier - Clinic/Group Practice 2769877000 Receives reassigned benefits from 10 practitioners
Practice locations: Nichols Hills, OK
O20250523001650 TX Part B Supplier - Clinic/Group Practice 2769877000 Receives reassigned benefits from 3 practitioners
Practice locations: Wichita Falls, TX

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 509
Overland Park, KS 66210
Phone (913) 429-3068

1301 Oak St
Fl 7
Kansas City, MO 64106
Phone (918) 231-8724

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

6440 Avondale Dr
Ste 20035
Nichols Hills, OK 73116
Phone (918) 231-8724

813 8th St
Ste 616
Wichita Falls, TX 76301
Phone (918) 231-8724

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1646956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747699200000",
    "number": "1306594148",
    "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": "6440 AVONDALE DR STE 202",
            "city": "NICHOLS HILLS",
            "state": "OK",
            "postal_code": "731166416",
            "telephone_number": "918-231-8724",
            "fax_number": "918-512-4063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENHANCED WOUND CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-11",
        "last_updated": "2025-05-20",
        "certification_date": "2025-05-20",
        "status": "A",
        "authorized_official_last_name": "HOLLEY",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_title_or_position": "PRESIDENT",
        "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 Nichols Hills, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 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.