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BREEDLOVE WOUND CARE OF OKLAHOMA LLC
NPI 1659183135
Surgery in Madill, OK

Active since January 22, 2025
207 E TALIAFERRO ST, MADILL, OK 73446(903) 947-2020 Get Directions Write a Review

NPPES record last updated: January 22, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Breedlove Wound Care Of Oklahoma Llc NPPES

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

BREEDLOVE WOUND CARE OF OKLAHOMA LLC (NPI 1659183135) is a healthcare organization registered as a surgery in Madill, Oklahoma and active in the NPI registry since January 2025. The organization lists Robert Wilson, Assistant Manager Credentialing, as its authorized official.

NPPES Registry Identity

NPI1659183135
Entity TypeOrganization
Primary Taxonomy208600000X
Legal Business NameBREEDLOVE WOUND CARE OF OKLAHOMA LLC
Location Address207 E TALIAFERRO STMadill, OK 73446-3410
Mailing AddressPo Box 1129Tatum, TX 75691-1129
Phone(903) 947-2020
Organization SubpartNo
Authorized OfficialRobert WilsonAssistant Manager Credentialing · (956) 331-2458
Enumeration DateJanuary 22, 2025
NPPES CertifiedJanuary 22, 2025
✔ NPI 1659183135 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
Definition
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
Also ListedFamily MedicineTaxonomy 207Q00000X
207 E TALIAFERRO ST, Madill, OK 73446
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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

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Breedlove Wound Care Of Oklahoma Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

7

Medicare enrollment records show 7 clinicians reassign Medicare billing to Breedlove Wound Care Of Oklahoma LLC, which bills Medicare for the services they deliver. They are listed nearest first.

Clinicians, nearest first (7)

Bailey Buck, DO
Family Practice
NPI 1457978934
1800 W UNIVERSITY BLVD
Durant, OK 74701
(580) 924-3080
✔ PECOS✔ Accepts Medicare20 mi
Randall Davault, M.D.
General Surgery
NPI 1457491904
1706 DELIVERY LN
Durant, OK 74701
(580) 924-0110
✔ PECOS✔ Accepts Medicare22 mi
Michael Cranford, DO
Family Practice
NPI 1528553153
1600 W UNIVERSITY BLVD
Durant, OK 74701
(580) 924-5500
✔ PECOS✔ Accepts Medicare23 mi
Haylie Mata
Nurse Practitioner
NPI 1992525976
50 E 2040 RD
Boswell, OK 74727
(580) 920-5870
✔ PECOS✔ Accepts Medicare52 mi
Jodie Moore, APRN-CNP
Nurse Practitioner
NPI 1669031266
415 6TH ST
Boswell, OK 74727
(580) 566-2530
✔ PECOS✔ Accepts Medicare52 mi
Ashley Smalling, ARNP
Nurse Practitioner
NPI 1467860189
4300 W MEMORIAL RD
Oklahoma City, OK 73120
(405) 752-3544
✔ PECOS115 mi
Martin Taylor, MD
Family Practice
NPI 1578535092
189 FM 3459 STE 400
Onalaska, TX 77360
(936) 649-1200
✔ PECOS✔ Accepts Medicare246 mi

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 Breedlove Wound Care Of Oklahoma LLC's NPI number?

The NPI number for Breedlove Wound Care Of Oklahoma LLC is 1659183135. It was assigned to this organization in the NPPES registry on January 22, 2025.

Where is Breedlove Wound Care Of Oklahoma LLC located?

Breedlove Wound Care Of Oklahoma LLC is located at 207 E Taliaferro St, Madill, OK 73446. The listed phone number is (903) 947-2020.

What is Breedlove Wound Care Of Oklahoma LLC's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Is Breedlove Wound Care Of Oklahoma LLC enrolled in Medicare?

Yes. Breedlove Wound Care Of Oklahoma LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Breedlove Wound Care Of Oklahoma LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 7 clinicians in 3 Medicare specialties reassign their Medicare billing to Breedlove Wound Care Of Oklahoma 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. The largest specialties are Family Practice (3), Nurse Practitioner (3) and General Surgery (1). Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Breedlove Wound Care Of Oklahoma LLC was last updated on January 22, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 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.