Organization Active NPI

Wound Docs, LLC

  • Specialist
  • Las Vegas, NV
National Provider Identifier
1578326013
Registry record updated Oct 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
WOUND DOCS, LLC
Practice address
1770 N Buffalo Dr Ste 113
Las Vegas, NV 89128-2678
Phone
(702) 650-0009
Fax
(702) 906-0067
NPI assigned
Feb 6, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2024

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

Authorized official

Name
Ejaz Kamboj, MDNPI 1396833810
Title
Ceo
Phone
(702) 726-9722

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
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

1770 N Buffalo Dr Ste 113
Las Vegas, NV 89128-2678

Mailing address

1770 N Buffalo Dr Ste 113
Las Vegas, NV 89128-2678
Phone (702) 650-0009

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241023001779 NV Part B Supplier - Clinic/Group Practice 0547793002 Receives reassigned benefits from 1 practitioner
Practice locations: Las Vegas, NV

National Provider Directory

National Provider Directory

Locations

1770 N Buffalo Dr
Ste 113
Las Vegas, NV 89128
Phone (702) 650-0009

Practitioners & affiliated clinicians

Practitioners 1

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": "1707177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728864000000",
    "number": "1578326013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1770 N BUFFALO DR STE 113",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891282678",
            "telephone_number": "702-650-0009",
            "fax_number": "702-906-0067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1770 N BUFFALO DR STE 113",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891282678",
            "telephone_number": "702-650-0009",
            "fax_number": "702-906-0067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOUND DOCS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-06",
        "last_updated": "2024-10-14",
        "certification_date": "2024-10-14",
        "status": "A",
        "authorized_official_last_name": "KAMBOJ",
        "authorized_official_first_name": "EJAZ",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "702-726-9722",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2024; 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.