NPIMap

Organization Active NPI

Encore Wound Care - Kentucky, LLC

  • Physician Assistant
  • Lexington, KY
National Provider Identifier
1346009040
Registry record updated May 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Legal business name
ENCORE WOUND CARE - KENTUCKY, LLC
Practice address
2277 Thunderstick Dr Ste 300
Lexington, KY 40505-4877
Phone
(440) 652-8748
Fax
(440) 582-3171
NPI assigned
Mar 15, 2024
Last updated
May 20, 2025By the provider in NPPES
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
Matthew Legowski
Title
Operations
Phone
(609) 703-5097

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary
Nurse Practitioner 363L00000X

Addresses

Primary practice location

2277 Thunderstick Dr Ste 300
Lexington, KY 40505-4877

Mailing address

12301 Ridge Rd
North Royalton, OH 44133-3744
Phone (609) 703-5097

Other practice location 1

731 Bay Ave
Somers Point, NJ 08244-2378
Phone (440) 652-8748

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240529000448 KY Part B Supplier - Clinic/Group Practice 2264874866 Receives reassigned benefits from 19 practitioners
Practice locations: Lexington, KY

National Provider Directory

National Provider Directory

Locations

2277 Thunderstick Dr
Ste 300
Lexington, KY 40505
Phone (502) 552-3879

Practitioners & affiliated clinicians

Practitioners 22

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1710460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747699200000",
    "number": "1346009040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12301 RIDGE RD",
            "city": "NORTH ROYALTON",
            "state": "OH",
            "postal_code": "441333744",
            "telephone_number": "609-703-5097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2277 THUNDERSTICK DR STE 300",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405054877",
            "telephone_number": "440-652-8748",
            "fax_number": "440-582-3171"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "731 Bay Ave",
            "address_purpose": "LOCATION",
            "city": "Somers Point",
            "state": "NJ",
            "postal_code": "082442378",
            "country_code": "US",
            "telephone_number": "440-652-8748",
            "fax_number": "440-582-3171",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ENCORE WOUND CARE - KENTUCKY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-15",
        "last_updated": "2025-05-20",
        "certification_date": "2025-05-20",
        "status": "A",
        "authorized_official_last_name": "LEGOWSKI",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "OPERATIONS",
        "authorized_official_telephone_number": "609-703-5097"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

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.