Prime Wound & Foot Care Clinic Inc

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

PRIME WOUND & FOOT CARE CLINIC INC

Practice address

4050 Airport Center Dr Ste B2
Palm Springs, CA 92264-1216

Phone

(760) 318-0220

Fax

(760) 318-2288

NPI assigned

Jun 29, 2023

Organization subpart

No

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

Authorized official

Name

Russell Simon

Title

Owner

Phone

(442) 353-0488

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Jose Keyser Reyes, MD

  • Internal Medicine Physician
  • San Jose, CA
  • NPI 1952454274
  NPD

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

{
    "created_epoch": "1687996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703030400000",
    "number": "1396422671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4050 AIRPORT CENTER DR STE B2",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922641216",
            "telephone_number": "760-318-0220",
            "fax_number": "760-318-0220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4050 AIRPORT CENTER DR STE B2",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922641216",
            "telephone_number": "760-318-0220",
            "fax_number": "760-318-2288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME WOUND & FOOT CARE CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-29",
        "last_updated": "2023-12-20",
        "certification_date": "2023-12-20",
        "status": "A",
        "authorized_official_last_name": "SIMON",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "442-353-0488"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vashaun William Price
• Morgan Seth Pricer, RADT, CMT
• Sofia Castaneda Prieto, MFT
• Primary Critical Care Limited Partnership
• Prime Health Assessment Medical Group Inc
• Primte Timer of the Desert Foundation
• Professional Medical Warehouse, Inc.
• Progressive Care Partners, Inc.
• Prosthetic & Orthotic Management Inc
• Sarah Pruden

• Clinic/Center in Palm Springs, CA
• Providers in Palm Springs, CA by specialty
• Clinic/Center in California

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