PROVIDENCE WOUND CARE SPECIALISTS, LLC
NPI 1578426813
Nurse Practitioner - Family in Noblesville, IN
About Providence Wound Care Specialists, Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PROVIDENCE WOUND CARE SPECIALISTS, LLC (NPI 1578426813) is a healthcare organization registered as a family in Noblesville, Indiana and active in the NPI registry since December 2025. The organization lists Jaekar Teah, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
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)
Providence Wound Care Specialists, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Providence Wound Care Specialists, LLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
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 Providence Wound Care Specialists, LLC's NPI number?
The NPI number for Providence Wound Care Specialists, LLC is 1578426813. It was assigned to this organization in the NPPES registry on December 4, 2025.
Where is Providence Wound Care Specialists, LLC located?
Providence Wound Care Specialists, LLC is located at 10917 Gossamer Ln, Noblesville, IN 46060. The listed phone number is (317) 365-6977.
What is Providence Wound Care Specialists, LLC's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Providence Wound Care Specialists, LLC enrolled in Medicare?
Yes. Providence Wound Care Specialists, LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Providence Wound Care Specialists, LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Providence Wound Care Specialists, LLC. 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 Providence Wound Care Specialists, LLC was last updated on January 12, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.
# Providence Wound Care Specialists, Llc · NPI 1578426813
Family organization in Noblesville, Indiana. Organization record, active in the CMS NPPES registry since December 4, 2025.
## Identity
- **NPI:** 1578426813 (Entity type: Organization)
- **Enumerated:** December 4, 2025
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **Organization subpart:** No
- **Authorized official:** Jaekar Teah, OWNER
## Practice location
- **Address:** 10917 GOSSAMER LN, Noblesville, IN 46060-6106
- **Phone:** (317) 365-6977 · **Fax:** (317) 642-0687
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Nurse Practitioner) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** January 12, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1578426813) · Data from the CMS NPPES public registry.