| Crescent Wound Care Inc | |
|
87 Generations Dr Spencer TN 38585-3027 | |
| (931) 946-7768 | |
| (931) 946-7875 |
| Full Name | Crescent Wound Care Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 87 Generations Dr, Spencer, Tennessee |
| Authorized Official Name and Position | Mohamed Kadry-hassanein (OWNER) |
| Authorized Official Contact | 8589673070 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Crescent Wound Care Inc 5580 La Jolla Blvd Ste 622 La Jolla CA 92037-7651 Ph: (931) 946-7768 | Crescent Wound Care Inc 87 Generations Dr Spencer TN 38585-3027 Ph: (931) 946-7768 |
| NPI Number | 1538957436 |
|---|---|
| Provider Enumeration Date | 04/29/2025 |
| Last Update Date | 09/28/2026 |
| Certification Date | 09/28/2026 |
| Medicare PECOS PAC ID | 3274914502 |
|---|---|
| Medicare Enrollment ID | O20250516000987 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538957436 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (NU) | Primary |
| 207R00000X | Internal Medicine | (NU) | Secondary |
| 208600000X | Surgery | (NU) | Secondary |
| Provider Name | Robert a Shearer |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1134142987 PECOS PAC ID: 1355342338 Enrollment ID: I20070117000281 |
| Provider Name | Allen Roy Walker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376580159 PECOS PAC ID: 3779557129 Enrollment ID: I20090810000663 |
| Provider Name | Jonathan Moore |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1598841322 PECOS PAC ID: 8426180233 Enrollment ID: I20231101002971 |
| Provider Name | Kristina Mouksian |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346703139 PECOS PAC ID: 8527301506 Enrollment ID: I20250210000016 |
Cumberland Family Care Van Buren Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 817 College St, Spencer, TN 38585 Phone: 931-946-2113 Fax: 931-946-2248 |
Integrity Wound Physicians Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 87 Generations Dr, Spencer, TN 38585 Phone: 931-946-7768 Fax: 858-431-4736 |