Organization Active NPI

Inside Out Advanced Wound Care LLC

  • Plastic and Reconstructive Surgery Physician
  • Atlanta, GA
National Provider Identifier
1407724164
Registry record updated Jun 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
Legal business name
INSIDE OUT ADVANCED WOUND CARE LLC
Practice address
1 Baltimore PL NW Ste 400
Atlanta, GA 30308-2117
Phone
(404) 680-2653
NPI assigned
Oct 24, 2025
Last updated
Jun 19, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2026

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

Authorized official

Name
Miranda Bowen
Title
Credentialing
Phone
(615) 504-1984

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery Physician 2086S0122X Primary

Addresses

Primary practice location

1 Baltimore PL NW Ste 400
Atlanta, GA 30308-2117

Mailing address

1 Baltimore PL NW Ste 400
Atlanta, GA 30308-2117
Phone (404) 680-2653

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260203000713 GA Part B Supplier - Clinic/Group Practice 7113405911 Receives reassigned benefits from 1 practitioner
Practice locations: Atlanta, GA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1761264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1781827200000",
    "number": "1407724164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 BALTIMORE PL NW STE 400",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303082117",
            "telephone_number": "404-680-2653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BALTIMORE PL NW STE 400",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303082117",
            "telephone_number": "404-680-2653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INSIDE OUT ADVANCED WOUND CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-10-24",
        "last_updated": "2026-06-19",
        "certification_date": "2026-06-19",
        "status": "A",
        "authorized_official_last_name": "BOWEN",
        "authorized_official_first_name": "MIRANDA",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "615-504-1984"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2026; 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.