Organization Active NPI

Dynamic Wound Care of South Carolina LLC

  • General Practice Physician
  • Spartanburg, SC
National Provider Identifier
1821961962
Registry record updated Feb 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
DYNAMIC WOUND CARE OF SOUTH CAROLINA LLC
Practice address
324 N Pine St
Spartanburg, SC 29302-1631
Phone
(305) 901-5055
NPI assigned
Sep 25, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2026

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

Authorized official

Name
Kirill Filatov
Title
Cfo
Phone
(305) 901-5055

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

324 N Pine St
Spartanburg, SC 29302-1631

Mailing address

324 N Pine St
Spartanburg, SC 29302-1631
Phone (305) 901-5055

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260218002499 SC Part B Supplier - Clinic/Group Practice 7517447451 Receives reassigned benefits from 2 practitioners
Practice locations: Spartanburg, SC

National Provider Directory

National Provider Directory

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": "1758758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770854400000",
    "number": "1821961962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "324 N PINE ST",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293021631",
            "telephone_number": "305-901-5055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 N PINE ST",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293021631",
            "telephone_number": "305-901-5055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DYNAMIC WOUND CARE OF SOUTH CAROLINA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-25",
        "last_updated": "2026-02-12",
        "certification_date": "2026-02-12",
        "status": "A",
        "authorized_official_last_name": "FILATOV",
        "authorized_official_first_name": "KIRILL",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "305-901-5055"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spartanburg, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2026; 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.