Integra Mobile Wound Care LLC

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

Legal business name

INTEGRA MOBILE WOUND CARE LLC

Practice address

1990 Milfield Cirlce
Snellville, GA 30078

Phone

(315) 529-5251

NPI assigned

Dec 14, 2023

Organization subpart

No

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

Authorized official

Name

Charmaine Baker, MDNPI 1730451345

Title

Co-Owner

Phone

(315) 529-5251

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Charmaine Cameron Baker, M.D.

  • Pediatrics Physician
  • Snellville, GA
  • NPI 1730451345
  Medicare reassignment NPD Authorized official
• Ronald W Baker Sr., MD

  • Orthopaedic Surgery Physician
  • Lawrenceville, GA
  • NPI 1407805666
  Medicare reassignment NPD

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

{
    "created_epoch": "1702512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703635200000",
    "number": "1992573380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 SCENIC HWY S",
            "address_2": "STE #1701-244",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300456359",
            "telephone_number": "315-529-5251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1990 MILFIELD CIRLCE",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "30078",
            "telephone_number": "315-529-5251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRA MOBILE WOUND CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-14",
        "last_updated": "2023-12-27",
        "certification_date": "2023-12-27",
        "status": "A",
        "authorized_official_last_name": "BAKER",
        "authorized_official_first_name": "CHARMAINE",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "315-529-5251",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Orthopaedic Surgery Physician in Snellville, GA
• Providers in Snellville, GA by specialty
• Orthopaedic Surgery Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2023; 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.