Columbus Diabetes & Wound Care Center LLC
Surgery in Columbus, GA. Organization (NPI-2).
NPI number1710790100
StatusActive
Last updated in NPPESAug 1, 2026
Details
- NPI
- 1710790100
- Entity type
- Organization (NPI-2)
- Legal business name
- Columbus Diabetes & Wound Care Center LLC
- Organization subpart
- No
- Enumeration date
- Jan 29, 2025
- Certification date
- Aug 1, 2026
- Last updated
- Aug 1, 2026
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PART B SUPPLIER - CLINIC/GROUP PRACTICE
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208600000X | Surgery | – | – | Yes |
| 207Q00000X | Family Medicine | – | – | |
| 363L00000X | Nurse Practitioner | – | – | |
| 363LF0000X | Nurse Practitioner, Family | – | – |
Practice location
2300 Manchester Expy Ste H202Columbus, GA 31904-6803
Phone 706-257-7680 · Fax 706-257-7681
Mailing address
2300 Manchester Expy Ste H202Columbus, GA 31904-6803
Phone 706-257-7680 · Fax 706-257-7681
Authorized official
Tyler Stout
Manager
3373157927
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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