NPIMap

Organization Active NPI

Integrity Wound Care LLC

  • Surgery Physician
  • Columbus, OH
National Provider Identifier
1861719452
Registry record updated Aug 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
35078625 Issued in OH
Legal business name
INTEGRITY WOUND CARE LLC
Practice address
5965 E Broad St Ste 120
Columbus, OH 43213-1562
Phone
(614) 234-6588
Fax
(614) 234-7109
NPI assigned
Apr 22, 2010
Last updated
Aug 5, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2024

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

Authorized official

Name
Michael D Goodyear II, MDNPI 1962499822
Title
Owner
Phone
(614) 657-2069

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
Surgery Physician 208600000X 35078625 OH Primary

Addresses

Primary practice location

5965 E Broad St Ste 120
Columbus, OH 43213-1562

Mailing address

2907 Sandycombe Dr
New Albany, OH 43054-7575
Phone (614) 657-2069

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100608000728 OH Part B Supplier - Clinic/Group Practice 7012047624 Receives reassigned benefits from 1 practitioner
Practice locations: Westerville, OH; Columbus, OH

National Provider Directory

National Provider Directory

Locations

5975 E Broad St
Columbus, OH 43213
Phone (614) 234-6588

920 N Hamilton Rd
Gahanna, OH 43230
Phone (614) 293-2614

500 S Cleveland Ave
Ste 203
Westerville, OH 43081
Phone (614) 898-4346

Practitioners & affiliated clinicians

Practitioners 5

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": "1271894400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722816000000",
    "number": "1861719452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2907 SANDYCOMBE DR",
            "city": "NEW ALBANY",
            "state": "OH",
            "postal_code": "430547575",
            "telephone_number": "614-657-2069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5965 E BROAD ST STE 120",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432131562",
            "telephone_number": "614-234-6588",
            "fax_number": "614-234-7109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRITY WOUND CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-22",
        "last_updated": "2024-08-05",
        "certification_date": "2024-08-05",
        "status": "A",
        "authorized_official_last_name": "GOODYEAR",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "614-657-2069",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OH",
            "license": "35078625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 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.