Organization Active NPI

Cornerstone Wound, LLC

  • Family Medicine Physician
  • Omaha, NE
National Provider Identifier
1447127246
Registry record updated Oct 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
CORNERSTONE WOUND, LLC
Practice address
11837 Miracle Hills Dr Ste 200
Omaha, NE 68154-4418
Phone
(402) 251-2136
NPI assigned
Oct 17, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2025

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

Authorized official

Name
Todd Colgrove
Title
Owner
Phone
(402) 218-1242

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

11837 Miracle Hills Dr Ste 200
Omaha, NE 68154-4418

Mailing address

11837 Miracle Hills Dr Ste 200
Omaha, NE 68154-4418
Phone (402) 251-2136

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260309001292 NE Part B Supplier - Clinic/Group Practice 8527541549 Receives reassigned benefits from 1 practitioner
Practice locations: Omaha, NE

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1760659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760659200000",
    "number": "1447127246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11837 MIRACLE HILLS DR STE 200",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681544418",
            "telephone_number": "402-251-2136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11837 MIRACLE HILLS DR STE 200",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681544418",
            "telephone_number": "402-251-2136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORNERSTONE WOUND, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-10-17",
        "last_updated": "2025-10-17",
        "certification_date": "2025-10-17",
        "status": "A",
        "authorized_official_last_name": "COLGROVE",
        "authorized_official_first_name": "TODD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "402-218-1242"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 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.