WOUND COMPANY PROVIDER GROUP, INC.
NPI 1114635174
Registered Nurse - Wound Care in Minneapolis, MN

Q: What is Wound Company Provider Group, Inc.'s NPI number?

The NPI number for Wound Company Provider Group, Inc. is 1114635174. It was assigned to this organization in the NPPES registry on November 9, 2022. The provider was formerly known as Sanford E Roberts III MD, Inc..

Q: What is Wound Company Provider Group, Inc.'s specialty?

The primary specialty registered for this NPI is Registered Nurse, specializing in Wound Care, with taxonomy code 163WW0000X.

Active since November 09, 2022

2240 DREW AVE S, MINNEAPOLIS, MN 55416(858) 774-6305 Get Directions Write a Review

NPPES record last updated: July 18, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 18, 2023, Jun 2, 2023, May 9, 2023 and 3 more (6 updates tracked since 2022).

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About Wound Company Provider Group, Inc. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WOUND COMPANY PROVIDER GROUP, INC. (NPI 1114635174), doing business as Sanford E Roberts Iii Md, Inc., is a healthcare organization registered as a wound care in Minneapolis, Minnesota and active in the NPI registry since November 2022. The organization lists Brantley Tilman Jolly, President, as its authorized official.

NPPES Registry Identity

NPI1114635174

Entity TypeOrganization

Primary Taxonomy163WW0000X

Legal Business NameWOUND COMPANY PROVIDER GROUP, INC.

Location Address2240 DREW AVE SMinneapolis, MN 55416-3646

Mailing Address2240 Drew Ave SMinneapolis, MN 55416-3646 · (858) 774-6305

Phone(858) 774-6305

Organization SubpartNo

Authorized OfficialBrantley Tilman JollyPresident · (703) 447-6897

Enumeration DateNovember 9, 2022

Last NPPES UpdateJuly 18, 20236 updates tracked since enumeration

NPPES CertifiedJuly 18, 2023

✔ NPI 1114635174 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyRegistered Nurse · Wound CareNursing Service Providers

Taxonomy Code163WW0000X

Also ListedRegistered Nurse · Continence CareTaxonomy 163WC2100X

Also ListedRegistered Nurse · Enterostomal TherapyTaxonomy 163WE0900X

2240 DREW AVE S, Minneapolis, MN 55416

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Other Names 1

Former Legal Business NameSanford E Roberts Iii Md, Inc.

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Medica.Insurance ›

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JULIE LEE ROSKAMP RN, CWOCN

Registered Nurse (Wound Care)