Organization Active NPI

Optimum Wound Care LLC

  • Clinic/Center
  • Louisville, KY
National Provider Identifier
1376269530
Registry record updated Jan 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
OPTIMUM WOUND CARE LLC
Practice address
9115 Leesgate Rd Ste C
Louisville, KY 40222-6017
Phone
(502) 999-2308
NPI assigned
Oct 18, 2022
Last updated
Jan 30, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2023

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

Authorized official

Name
Mosayeb KarimiNPI 1235895095
Title
Ceo
Phone
(502) 999-2308

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NU Primary

Addresses

Primary practice location

9115 Leesgate Rd Ste C
Louisville, KY 40222-6017

Mailing address

9115 Leesgate Rd Ste C
Louisville, KY 40222-6017

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230217002703 KY Part B Supplier - Clinic/Group Practice 6305218462 Receives reassigned benefits from 2 practitioners
Practice locations: Louisville, KY

National Provider Directory

National Provider Directory

Locations

9115 Leesgate Rd
Ste C
Louisville, KY 40222
Phone (502) 719-0782

Practitioners & affiliated clinicians

Practitioners 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1666051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675036800000",
    "number": "1376269530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9115 LEESGATE RD STE C",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402226017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9115 LEESGATE RD STE C",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402226017",
            "telephone_number": "502-999-2308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMUM WOUND CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-18",
        "last_updated": "2023-01-30",
        "certification_date": "2023-01-30",
        "status": "A",
        "authorized_official_last_name": "KARIMI",
        "authorized_official_first_name": "MOSAYEB",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "502-999-2308"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

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