Premier Wound Care of Tennessee, PC
NPI 1104702729ActiveOrganization· Nurse Practitioner, Family· Morristown, TN
Nurse Practitioner, Family in Morristown, Tennessee, registered in NPPES in August 2025. The authorized official on file is Leonard Hales, Credentialing. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1104702729 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Aug 12, 2025 |
| Last updated in NPPES | Jun 10, 2026 |
| Certified by provider | Jun 10, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner, Family Primary | 363LF0000X | — | — |
| Clinic/Center, Medical Specialty | 261QM2500X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (TN) |
|---|
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