Precision Wound Care Alliance LLC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Legal business name

PRECISION WOUND CARE ALLIANCE LLC

Practice address

8515 Amerivan Dr
Louisville, KY 40299-1102

Phone

(502) 299-9624

NPI assigned

May 15, 2023

Organization subpart

No

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

Authorized official

Name

Juan Carlos Afable

Title

Manager

Phone

(502) 299-9624

Specialties & licenses 5

Addresses

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

{
    "created_epoch": "1684108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696032000000",
    "number": "1336830041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20025 SOUTHERN STAR DR",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349454704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8515 AMERIVAN DR",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402991102",
            "telephone_number": "502-299-9624"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20025 Southern Star Dr",
            "address_purpose": "LOCATION",
            "city": "Fort Pierce",
            "state": "FL",
            "postal_code": "349454704",
            "country_code": "US",
            "telephone_number": "502-299-9624",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PRECISION WOUND CARE ALLIANCE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-15",
        "last_updated": "2023-09-30",
        "certification_date": "2023-09-30",
        "status": "A",
        "authorized_official_last_name": "AFABLE",
        "authorized_official_first_name": "JUAN CARLOS",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "502-299-9624"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Gerontology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nurse Practitioner in Louisville, KY
• Providers in Louisville, KY by specialty
• Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2023; 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.