PROACTIVE WOUND CARE ID INC.
NPI 1134928419
Podiatrist in Fish Haven, ID
About Proactive Wound Care Id Inc. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PROACTIVE WOUND CARE ID INC. (NPI 1134928419) is a healthcare organization registered as a podiatrist in Fish Haven, Idaho and active in the NPI registry since March 2025. The organization lists Hayley Williams, Office Manager, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Proactive Wound Care Id Inc. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
3Medicare enrollment records show 3 clinicians reassign Medicare billing to Proactive Wound Care Id Inc., which bills Medicare for the services they deliver. They are listed nearest first.
Clinicians, nearest first (3)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Proactive Wound Care Id Inc.'s NPI number?
The NPI number for Proactive Wound Care Id Inc. is 1134928419. It was assigned to this organization in the NPPES registry on March 10, 2025.
Where is Proactive Wound Care Id Inc. located?
Proactive Wound Care Id Inc. is located at 2270 Highway 89, Fish Haven, ID 83287. The listed phone number is (801) 815-6862.
What is Proactive Wound Care Id Inc.'s specialty?
The primary specialty registered for this NPI is Podiatrist with taxonomy code 213E00000X.
Is Proactive Wound Care Id Inc. enrolled in Medicare?
Yes. Proactive Wound Care Id Inc. is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Proactive Wound Care Id Inc.?
According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians reassign their Medicare billing to Proactive Wound Care Id Inc., in Nurse Practitioner and Podiatry. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Proactive Wound Care Id Inc. was last updated on March 10, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Proactive Wound Care Id Inc. · NPI 1134928419
Podiatrist organization in Fish Haven, Idaho. Organization record, active in the CMS NPPES registry since March 10, 2025.
## Identity
- **NPI:** 1134928419 (Entity type: Organization)
- **Enumerated:** March 10, 2025
- **Primary specialty:** Podiatrist · taxonomy 213E00000X
- **Organization subpart:** No
- **Authorized official:** Hayley Williams, OFFICE MANAGER
## Practice location
- **Address:** 2270 HIGHWAY 89, Fish Haven, ID 83287-5139
- **Phone:** (801) 815-6862
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 3 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Podiatry (2), Nurse Practitioner (1) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** March 10, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1134928419) · Data from the CMS NPPES public registry.