Wanda Castillo, PROSTHETIC SPECIALIS

Primary specialty

Prosthetics Case ManagementTaxonomy code 1744P3200X

License

865310909 Issued in LA

Practice address

530 Providence St
New Iberia, LA 70560-4431

Phone

(337) 577-2331

NPI assigned

Sep 19, 2022

Last updated

Feb 24, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kulture Kouture LLC

  • Durable Medical Equipment & Medical Supplies
  • New Iberia, LA
  • NPI 1902528649
  NPD Authorized official

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

{
    "created_epoch": "1663545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677196800000",
    "number": "1639891468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 ANDERSON ST",
            "city": "NEW IBERIA",
            "state": "LA",
            "postal_code": "705604138",
            "telephone_number": "337-577-2331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 PROVIDENCE ST",
            "city": "NEW IBERIA",
            "state": "LA",
            "postal_code": "705604431",
            "telephone_number": "337-577-2331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASTILLO",
        "first_name": "WANDA",
        "credential": "PROSTHETIC SPECIALIS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-19",
        "last_updated": "2023-02-24",
        "certification_date": "2022-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1744P3200X",
            "taxonomy_group": "",
            "desc": "Specialist, Prosthetics Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1744P3200X",
            "taxonomy_group": "",
            "desc": "Specialist, Prosthetics Case Management",
            "state": "LA",
            "license": "865310909",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ra'Monika Carter
• Breigh B Casanova, PT, DPT
• Michael James Cason, D.D.S.
• Brady John Castille
• Timothy Castille
• Caswell Orthopedic Clinic
• Kyle Allen Caswell, D.O.
• Anna Catherine Cavalier, HIS
• Dave Joseph Cavalier III, M.S., CCC-A
• Teosha Tichelle Celestine

• Prosthetics Case Management in New Iberia, LA
• Providers in New Iberia, LA by specialty
• Prosthetics Case Management in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2023; 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.