Organization Active NPI

Wound Care Medical Mississippi LLC

  • Nurse Practitioner
  • Madison, MS
National Provider Identifier
1629870035
Registry record updated Apr 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
WOUND CARE MEDICAL MISSISSIPPI LLC
Practice address
Attn: Wound Care Medical Mississippi LLC
109 Executive Drive, Suite 3
Madison, MS 39110
Phone
(737) 703-8191
Fax
(512) 243-6916
NPI assigned
Mar 26, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2025

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

Authorized official

Name
Michael Seestadt
Title
Owner
Phone
(737) 703-8191

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X Primary

Addresses

Primary practice location

Attn: Wound Care Medical Mississippi LLC
109 Executive Drive, Suite 3
Madison, MS 39110

Mailing address

8161 Highway 100 Ste 264
Nashville, TN 37221-4213
Phone (737) 703-8191

Other names 1

  • WOUND CARE MEDICAL MISSISSIPPI LLC Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250813004420 MS Part B Supplier - Clinic/Group Practice 7911405386 Receives reassigned benefits from 2 practitioners
Practice locations: Madison, MS

National Provider Directory

National Provider Directory

Locations

701 S Capital of Texas Hwy
Ste D420
West Lake Hills, TX 78746

Practitioners & affiliated clinicians

Practitioners 2

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": "1742947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744934400000",
    "number": "1629870035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8161 HIGHWAY 100 STE 264",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372214213",
            "telephone_number": "737-703-8191",
            "fax_number": "512-243-6916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ATTN: WOUND CARE MEDICAL MISSISSIPPI LLC",
            "address_2": "109 EXECUTIVE DRIVE, SUITE 3",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "39110",
            "telephone_number": "737-703-8191",
            "fax_number": "512-243-6916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOUND CARE MEDICAL MISSISSIPPI LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-26",
        "last_updated": "2025-04-18",
        "certification_date": "2025-04-18",
        "status": "A",
        "authorized_official_last_name": "SEESTADT",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "737-703-8191"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WOUND CARE MEDICAL MISSISSIPPI LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "WOUND CARE MEDICAL MISSISSIPPI LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Madison, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 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.