BREEDLOVE WOUND CARE OF OKLAHOMA LLC – Surgery Physician, NPI 1659183135

BREEDLOVE WOUND CARE OF OKLAHOMA LLC is a healthcare provider. based in Madill, Oklahoma. specializing in Surgery Physician. The NPI Number for BREEDLOVE WOUND CARE OF OKLAHOMA LLC is 1659183135

Main info

Organization
Name
BREEDLOVE WOUND CARE OF OKLAHOMA LLC
NPI
1659183135
Phone
(903) 947-2020
Address
207 E TALIAFERRO ST
Authorized Official
ROBERT WILSON ASSISTANT MANAGER CREDENTIALING
Enumeration Date
22 January 2025
Last Update Date
22 January 2025
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience22
Completeness75
Years active:1State licenses:0Digital endpointsOther names

Provider Addresses for BREEDLOVE WOUND CARE OF OKLAHOMA LLC

  • 207 E TALIAFERRO ST

    MADILL, OK 734463410

    Phone: (903) 947-2020

    Type: Location

  • PO BOX 1129

    TATUM, TX 756911129

    Phone:

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-03-12

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20250312001828OClinic/Group PracticeOKTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 73446)

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Reviews

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Frequently asked questions

What is BREEDLOVE WOUND CARE OF OKLAHOMA LLC's NPI number?
BREEDLOVE WOUND CARE OF OKLAHOMA LLC's NPI is 1659183135 — the number used across U.S. healthcare to identify this provider.
Is BREEDLOVE WOUND CARE OF OKLAHOMA LLC shown as active in public data?
Registry records indicate BREEDLOVE WOUND CARE OF OKLAHOMA LLC maintains an active NPI.
What clinical focus is listed for BREEDLOVE WOUND CARE OF OKLAHOMA LLC?
At a glance, BREEDLOVE WOUND CARE OF OKLAHOMA LLC is tied to Surgery Physician. Clinical services aligned with this taxonomy classification.
Is BREEDLOVE WOUND CARE OF OKLAHOMA LLC located near Madill?
BREEDLOVE WOUND CARE OF OKLAHOMA LLC currently maps to Madill, Oklahoma in this extract.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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