| American Wound Care Centers | |
|
5055 Maryland Way Ste 100 Brentwood TN 37027-7665 | |
| (615) 229-7202 | |
| Not Available |
| Full Name | American Wound Care Centers |
|---|---|
| Speciality | Family Medicine |
| Location | 5055 Maryland Way Ste 100, Brentwood, Tennessee |
| Authorized Official Name and Position | Ethan Kellum (OWNER) |
| Authorized Official Contact | 9014840837 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| American Wound Care Centers 5055 Maryland Way Ste 100 Brentwood TN 37027-7665 Ph: () - | American Wound Care Centers 5055 Maryland Way Ste 100 Brentwood TN 37027-7665 Ph: (615) 229-7202 |
| NPI Number | 1306585500 |
|---|---|
| Provider Enumeration Date | 06/03/2022 |
| Last Update Date | 06/03/2022 |
| Medicare PECOS PAC ID | 0648650853 |
|---|---|
| Medicare Enrollment ID | O20220706001930 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306585500 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QA0505X | Family Medicine - Adult Medicine | (* (Not Available)) | Primary |
| Provider Name | Hemal V Mehta |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1174533772 PECOS PAC ID: 7719935956 Enrollment ID: I20050105000169 |
| Provider Name | Casey Erin Ingle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366786428 PECOS PAC ID: 3870890221 Enrollment ID: I20160330000104 |
| Provider Name | Ethan Kellum |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1396907705 PECOS PAC ID: 5092958199 Enrollment ID: I20161205000206 |
| Provider Name | Jennifer Salamone |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326799347 PECOS PAC ID: 6305228081 Enrollment ID: I20220727002086 |
| Provider Name | Brittany Jordan Ferguson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225720915 PECOS PAC ID: 0749642221 Enrollment ID: I20230815003500 |
| Provider Name | Ashley Dawn Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386322774 PECOS PAC ID: 4082059811 Enrollment ID: I20240301003033 |
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