Wound Pros South Carolina

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

WOUND PROS SOUTH CAROLINA

Practice address

528 Broad St Ste 102
Sumter, SC 29150-3368

Phone

(323) 480-4075

NPI assigned

Oct 26, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Owen Bernardo Ellington, MD

Title

President

Phone

(713) 304-4227

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1666742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666742400000",
    "number": "1598482937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5901 W CENTURY BLVD STE 750",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455443",
            "telephone_number": "323-480-4075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "528 BROAD ST STE 102",
            "city": "SUMTER",
            "state": "SC",
            "postal_code": "291503368",
            "telephone_number": "323-480-4075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOUND PROS SOUTH CAROLINA",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-26",
        "last_updated": "2022-10-26",
        "certification_date": "2022-10-26",
        "status": "A",
        "authorized_official_last_name": "ELLINGTON",
        "authorized_official_first_name": "OWEN",
        "authorized_official_middle_name": "BERNARDO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "713-304-4227",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keywanna Witherspoon
• Suwarat Wongjittraporn, MD
• Marjorie Wheeler Woodham
• Kristen Woods
• Eric Wooten, PMHNP-BC
• Tekisha Wright Hatcher
• Michelle Taureen Wright
• Saravia Wright
• Tyquandria Wright
• Sally Rebekah Yoder, LPC

• General Practice Physician in Sumter, SC
• Providers in Sumter, SC by specialty
• General Practice Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2022; 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.