| Cornerstone Wound, LLC | |
|
11837 Miracle Hills Dr Ste 200 Omaha NE 68154-4418 | |
| (402) 251-2136 | |
| Not Available |
| Full Name | Cornerstone Wound, LLC |
|---|---|
| Speciality | Family Medicine |
| Location | 11837 Miracle Hills Dr Ste 200, Omaha, Nebraska |
| Authorized Official Name and Position | Todd Colgrove (OWNER) |
| Authorized Official Contact | 4022181242 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cornerstone Wound, LLC 11837 Miracle Hills Dr Ste 200 Omaha NE 68154-4418 Ph: (402) 251-2136 | Cornerstone Wound, LLC 11837 Miracle Hills Dr Ste 200 Omaha NE 68154-4418 Ph: (402) 251-2136 |
| NPI Number | 1447127246 |
|---|---|
| Provider Enumeration Date | 10/17/2025 |
| Last Update Date | 10/17/2025 |
| Certification Date | 10/17/2025 |
| Medicare PECOS PAC ID | 8527541549 |
|---|---|
| Medicare Enrollment ID | O20260309001292 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447127246 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Primary |
| Provider Name | Karissa Susan Reiser |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023607652 PECOS PAC ID: 3274046339 Enrollment ID: I20250701003580 |
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