NPIMap

Organization Active NPI

The Austin Diagnostic Clinic, PLLC

Doing business as Austin Diagnostic Clinic

  • Rheumatology Physician
  • Austin, TX
National Provider Identifier
1003881368
Registry record updated Jun 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
Legal business name
THE AUSTIN DIAGNOSTIC CLINIC, PLLC
Doing business as
Austin Diagnostic Clinic
Practice address
12221 N Mo Pac Expy
Dept of Rheumatology
Austin, TX 78758
Phone
(512) 901-4018
Fax
(512) 901-3918
NPI assigned
Feb 21, 2006
Last updated
Jun 25, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
John Rebok
Title
Vice President
Phone
(615) 372-5004

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X NU Primary

Addresses

Primary practice location

12221 N Mo Pac Expy
Dept of Rheumatology
Austin, TX 78758

Mailing address

2000 Health Park Dr Dept of
Brentwood, TN 37027-4525
Phone (615) 372-5004

Other identifiers 1

IdentifierTypeStateIssuer
140347921MedicaidTX

Other names 1

  • Austin Diagnostic Clinic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
The Austin Diagnostic Clinic Association20 organizations share this tax ID, including this one

Other organizations with this tax ID 19

Organizations that report the same tax identification number in the National Provider Directory.

View all 19

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1140480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529884800000",
    "number": "1003881368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 HEALTH PARK DR DEPT OF",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370274525",
            "telephone_number": "615-372-5004",
            "fax_number": "866-831-4898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12221 N MO PAC EXPY",
            "address_2": "DEPT OF RHEUMATOLOGY",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "78758",
            "telephone_number": "512-901-4018",
            "fax_number": "512-901-3918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE AUSTIN DIAGNOSTIC CLINIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-21",
        "last_updated": "2018-06-25",
        "status": "A",
        "authorized_official_last_name": "REBOK",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "615-372-5004"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "140347921",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Austin Diagnostic Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Austin Diagnostic Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.