Organization Active NPI

Michigan Wound Care Specialists PLLC

  • Wound Care Registered Nurse
  • Mt Pleasant, MI
National Provider Identifier
1457040610
Registry record updated May 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Wound Care Registered NurseTaxonomy code 163WW0000X
Legal business name
MICHIGAN WOUND CARE SPECIALISTS PLLC
Practice address
4641 E Pickard St
Mt Pleasant, MI 48858-2007
Phone
(989) 948-4863
Fax
(989) 215-6501
NPI assigned
May 3, 2023
Last updated
May 3, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 3, 2023

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

Authorized official

Name
Jose RaygadaNPI 1063623981
Title
M.D
Phone
(989) 948-4863

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Wound Care Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163WW0000X Primary

Addresses

Primary practice location

4641 E Pickard St
Mt Pleasant, MI 48858-2007

Mailing address

2805 Peachtree Industrial Blvd Ste 213
Duluth, GA 30097-8171
Phone (678) 940-8115

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": "1683072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683072000000",
    "number": "1457040610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2805 PEACHTREE INDUSTRIAL BLVD STE 213",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300978171",
            "telephone_number": "678-940-8115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4641 E PICKARD ST",
            "city": "MT PLEASANT",
            "state": "MI",
            "postal_code": "488582007",
            "telephone_number": "989-948-4863",
            "fax_number": "989-215-6501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHIGAN WOUND CARE SPECIALISTS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-03",
        "last_updated": "2023-05-03",
        "certification_date": "2023-05-03",
        "status": "A",
        "authorized_official_last_name": "RAYGADA",
        "authorized_official_first_name": "JOSE",
        "authorized_official_title_or_position": "M.D",
        "authorized_official_telephone_number": "989-948-4863"
    },
    "taxonomies": [
        {
            "code": "163WW0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Wound Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mt Pleasant, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 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.