Wickenburg Diabetes & Wound Care Center LLC
NPI 1578361481 · Internal Medicine Physician · Wickenburg, AZ
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Wickenburg Diabetes & Wound Care Center LLC is a Internal Medicine Physician organization in Wickenburg, AZ (NPI 1578361481).
Provider details
- NPI number
- 1578361481
- Entity type
- Organization
- Primary specialty
- Internal Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Tyler Stout, Manager(337) 315-7927
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Family Nurse Practitioner363LF0000X
Physician Assistants & Advanced Practice Nursing Providers
- Nurse Practitioner363L00000X
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
1 yr in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2025-03-05
- Last updated
- 2025-11-06
- Certified
- 2025-11-06
Frequently asked questions
- What is Wickenburg Diabetes & Wound Care Center LLC's NPI number?
- Wickenburg Diabetes & Wound Care Center LLC's National Provider Identifier (NPI) is 1578361481, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Wickenburg Diabetes & Wound Care Center LLC?
- Wickenburg Diabetes & Wound Care Center LLC is classified in the NPPES registry as Internal Medicine Physician (Allopathic & Osteopathic Physicians).
- Where is Wickenburg Diabetes & Wound Care Center LLC located?
- Wickenburg Diabetes & Wound Care Center LLC's practice location on file with NPPES is 519 Rose Ln, Wickenburg, AZ 85390-1448.
- What is Wickenburg Diabetes & Wound Care Center LLC's phone number?
- The practice phone number listed in the NPPES registry for Wickenburg Diabetes & Wound Care Center LLC is (844) 888-0408.
- Does Wickenburg Diabetes & Wound Care Center LLC accept Medicare?
- Wickenburg Diabetes & Wound Care Center LLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Wickenburg Diabetes & Wound Care Center LLC?
- The authorized official listed on Wickenburg Diabetes & Wound Care Center LLC's NPPES record is Tyler Stout, Manager. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Wickenburg Diabetes & Wound Care Center LLC's NPI active?
- Yes — Wickenburg Diabetes & Wound Care Center LLC's NPI (1578361481) is active in the NPPES registry as of the last update on 2025-11-06.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.