Organization Active NPI

Wound MD Michigan Professional Limited Liability Company

  • Wound Care Registered Nurse
  • Dearborn, MI
National Provider Identifier
1669165247
Registry record updated May 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Wound Care Registered NurseTaxonomy code 163WW0000X
Legal business name
WOUND MD MICHIGAN PROFESSIONAL LIMITED LIABILITY COMPANY
Practice address
3200 Greenfield Rd Ste 300
Dearborn, MI 48120-1805
Phone
(855) 479-4217
Fax
(888) 557-9724
NPI assigned
May 31, 2023
Last updated
May 17, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 17, 2024

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

Authorized official

Name
Syed NaqviNPI 1649624602
Title
Owner
Phone
(251) 901-3011

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
Wound Care Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163WW0000X Primary

Addresses

Primary practice location

3200 Greenfield Rd Ste 300
Dearborn, MI 48120-1805

Mailing address

8133 Leesburg Pike Ste 630
Vienna, VA 22182-2730
Phone (855) 479-4217

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240212003905 MI Part B Supplier - Clinic/Group Practice 4486097979 Receives reassigned benefits from 2 practitioners
Practice locations: Dearborn, MI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1685491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715904000000",
    "number": "1669165247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8133 LEESBURG PIKE STE 630",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822730",
            "telephone_number": "855-479-4217",
            "fax_number": "888-557-9724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 GREENFIELD RD STE 300",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481201805",
            "telephone_number": "855-479-4217",
            "fax_number": "888-557-9724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOUND MD MICHIGAN PROFESSIONAL LIMITED LIABILITY COMPANY",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-31",
        "last_updated": "2024-05-17",
        "certification_date": "2024-05-17",
        "status": "A",
        "authorized_official_last_name": "NAQVI",
        "authorized_official_first_name": "SYED",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "251-901-3011"
    },
    "taxonomies": [
        {
            "code": "163WW0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Wound Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2024; 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.