NPIMap

Organization Active NPI

Pro-Active Wound Care Clinics LLC

  • Foot & Ankle Surgery Podiatrist
  • Dublin, OH
National Provider Identifier
1467485813
Registry record updated Nov 29, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
PRO-ACTIVE WOUND CARE CLINICS LLC
Practice address
5920 Wilcox PL
Suite E
Dublin, OH 43016-6802
Phone
(614) 336-3838
Fax
(614) 336-3933
NPI assigned
Jul 9, 2006
Last updated
Nov 29, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2007

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

Authorized official

Name
Kyle E Hoogendoorn, DPMNPI 1629135157
Title
Owner
Phone
(614) 366-3838

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
Foot & Ankle Surgery Podiatrist 213ES0103X NU Primary

Addresses

Primary practice location

5920 Wilcox PL
Suite E
Dublin, OH 43016-6802

Mailing address

5920 Wilcox PL
Suite E
Dublin, OH 43016-6802
Phone (614) 336-3838

Other identifiers 1

IdentifierTypeStateIssuer
2468986MedicaidOH

National Provider Directory

National Provider Directory

Locations

1300 Hill Rd N
Pickerington, OH 43147
Phone (330) 933-0922

Practitioners & affiliated clinicians

Practitioners 31

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.

View all 31

NPI Registry JSON

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196294400000",
    "number": "1467485813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5920 WILCOX PL",
            "address_2": "SUITE E",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430166802",
            "telephone_number": "614-336-3838",
            "fax_number": "614-336-3933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5920 WILCOX PL",
            "address_2": "SUITE E",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430166802",
            "telephone_number": "614-336-3838",
            "fax_number": "614-336-3933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRO-ACTIVE WOUND CARE CLINICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-09",
        "last_updated": "2007-11-29",
        "status": "A",
        "authorized_official_last_name": "HOOGENDOORN",
        "authorized_official_first_name": "KYLE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "614-366-3838",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2468986",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dublin, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2007; 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.