Organization Active NPI

Premier Wound Care PLLC

  • Adult Health Nurse Practitioner
  • Glastonbury, CT
National Provider Identifier
1619838000
Registry record updated Nov 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
Legal business name
PREMIER WOUND CARE PLLC
Practice address
2389 Main St
Glastonbury, CT 06033-4617
Phone
(860) 869-6536
NPI assigned
Nov 24, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2025

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

Authorized official

Name
Samuel Asomaning, APRNNPI 1881207595
Title
Manager
Phone
(860) 869-6536

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Wound Care Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163WW0000X
Adult Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LA2200X Primary

Addresses

Primary practice location

2389 Main St
Glastonbury, CT 06033-4617

Mailing address

65 Oak St
South Windsor, CT 06074-3113
Phone (860) 869-6536

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260415000648 CT Part B Supplier - Clinic/Group Practice 7113493404 Receives reassigned benefits from 1 practitioner
Practice locations: Glastonbury, CT

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.

NPI Registry JSON

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

{
    "created_epoch": "1763942400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1763942400000",
    "number": "1619838000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 OAK ST",
            "city": "SOUTH WINDSOR",
            "state": "CT",
            "postal_code": "060743113",
            "telephone_number": "860-869-6536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2389 MAIN ST",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060334617",
            "telephone_number": "860-869-6536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER WOUND CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-11-24",
        "last_updated": "2025-11-24",
        "certification_date": "2025-11-24",
        "status": "A",
        "authorized_official_last_name": "ASOMANING",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "860-869-6536",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "163WW0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Wound Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glastonbury, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2025; 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.