NPIMap

Organization Active NPI

Wound Solutions of Semo LLC

  • Clinic/Center
  • Kennett, MO
National Provider Identifier
1578340360
Registry record updated Dec 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
WOUND SOLUTIONS OF SEMO LLC
Practice address
1231 1St St Ste 8
Kennett, MO 63857-2521
Phone
(870) 898-0088
NPI assigned
Sep 13, 2023
Last updated
Dec 11, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2023

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

Authorized official

Name
Heather Stallings, APRNNPI 1013359769
Title
Owner
Phone
(870) 273-2799

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
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

1231 1St St Ste 8
Kennett, MO 63857-2521

Mailing address

1021 Neil Dr
Jonesboro, AR 72401-4462

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240117000309 MO Part B Supplier - Clinic/Group Practice 8325490261 Receives reassigned benefits from 3 practitioners
Practice locations: Kennett, MO

National Provider Directory

National Provider Directory

Locations

1021 Neil Dr
Ste 100
Jonesboro, AR 72401
Phone (870) 898-0088

103 S Main St
Ste 7
Kennett, MO 63857

Practitioners & affiliated clinicians

Practitioners 25

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 25

NPI Registry JSON

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

{
    "created_epoch": "1694563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702252800000",
    "number": "1578340360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 NEIL DR",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724014462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1231 1ST ST STE 8",
            "city": "KENNETT",
            "state": "MO",
            "postal_code": "638572521",
            "telephone_number": "870-898-0088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOUND SOLUTIONS OF SEMO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-13",
        "last_updated": "2023-12-11",
        "certification_date": "2023-12-11",
        "status": "A",
        "authorized_official_last_name": "STALLINGS",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "870-273-2799",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennett, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2023; 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.