| Dynamic Wound Care LLC | |
|
2222 Shadowlake Dr Oklahoma City OK 73159-7440 | |
| (405) 315-8440 | |
| (405) 653-1444 |
| Full Name | Dynamic Wound Care LLC |
|---|---|
| Speciality | Family Medicine |
| Location | 2222 Shadowlake Dr, Oklahoma City, Oklahoma |
| Authorized Official Name and Position | Brent Byers (OWNER) |
| Authorized Official Contact | 4053158440 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dynamic Wound Care LLC 2222 Shadowlake Dr Oklahoma City OK 73159-7440 Ph: (405) 554-3344 | Dynamic Wound Care LLC 2222 Shadowlake Dr Oklahoma City OK 73159-7440 Ph: (405) 315-8440 |
| NPI Number | 1598541427 |
|---|---|
| Provider Enumeration Date | 09/06/2023 |
| Last Update Date | 09/09/2026 |
| Certification Date | 09/09/2026 |
| Medicare PECOS PAC ID | 0143674465 |
|---|---|
| Medicare Enrollment ID | O20230920002667 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598541427 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Primary |
| Provider Name | Jeffry M Bryen |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1265491237 PECOS PAC ID: 7618881962 Enrollment ID: I20031119000517 |
| Provider Name | Jeanie M Loper |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750424404 PECOS PAC ID: 0547329096 Enrollment ID: I20081112000676 |
| Provider Name | Jeremy Michael Hurford |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1669845772 PECOS PAC ID: 5193029668 Enrollment ID: I20160203000773 |
| Provider Name | Brent Byers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659869881 PECOS PAC ID: 6204266240 Enrollment ID: I20200415001931 |
| Provider Name | Wendy Lynn Kincaid |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487387981 PECOS PAC ID: 3678957933 Enrollment ID: I20220906001148 |
| Provider Name | Christopher Gordon Bishop |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285410001 PECOS PAC ID: 7214382530 Enrollment ID: I20231006000388 |
| Provider Name | Mendy Renee Terrell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790980654 PECOS PAC ID: 9830489343 Enrollment ID: I20250203002826 |
| Provider Name | Angela S Riggs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801681416 PECOS PAC ID: 7810415452 Enrollment ID: I20250516002198 |
| Provider Name | Marena De Jesus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942017959 PECOS PAC ID: 3870090012 Enrollment ID: I20251006003998 |
| Provider Name | Chelsea Toliver Byler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386519148 PECOS PAC ID: 5698260875 Enrollment ID: I20251224002051 |
| Provider Name | Alexis Lynn Cralley |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1295120483 PECOS PAC ID: 0345553129 Enrollment ID: I20260118000049 |
| Provider Name | Mary Ann Buchanan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942015946 PECOS PAC ID: 9335610153 Enrollment ID: I20260602004562 |
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