=====================================================
General NPI Number Information
=====================================================
NPI Number | 1417602053
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ASCEND WOUND CARE LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/12/2022
-----------------------------------------------------
Last Update Date | 07/11/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 18104 HATCHELL RD
-----------------------------------------------------
City | TONGANOXIE
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 66086-5270
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 913-636-2140
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 361
-----------------------------------------------------
City | BASEHOR
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 66007-0361
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 913-636-2140
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | ANGELA VANDONGE
-----------------------------------------------------
Credential | NP
-----------------------------------------------------
Telephone | 913-636-2140
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363L00000X
-----------------------------------------------------
Taxonomy Name | Nurse Practitioner
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------