NPIMap

Organization Active NPI

Providence Health Alliance

Doing business as Ascension Medical Group Providence Urgent Care

  • Urgent Care Clinic/Center
  • Lacy Lakeview, TX
National Provider Identifier
1013783091
Registry record updated Nov 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
PROVIDENCE HEALTH ALLIANCE
Doing business as
Ascension Medical Group Providence Urgent Care
Practice address
1130 N Loop 340
Lacy Lakeview, TX 76705
Phone
(254) 870-6500
NPI assigned
Nov 30, 2023
Last updated
Nov 30, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2023

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

Authorized official

Name
Clayton Carsner
Title
VP/Coo
Phone
(512) 324-5846

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X Primary

Addresses

Primary practice location

1130 N Loop 340
Lacy Lakeview, TX 76705

Mailing address

1345 Philomena St
Ste 410.3
Austin, TX 78723

Other names 1

  • Ascension Medical Group Providence Urgent Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Ascension Medical Group Providence Urgent Care2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

NPI Registry JSON

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

{
    "created_epoch": "1701302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701302400000",
    "number": "1013783091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1345 PHILOMENA ST",
            "address_2": "STE 410.3",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "78723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 N LOOP 340",
            "city": "LACY LAKEVIEW",
            "state": "TX",
            "postal_code": "76705",
            "telephone_number": "254-870-6500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE HEALTH ALLIANCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-30",
        "last_updated": "2023-11-30",
        "status": "A",
        "authorized_official_last_name": "CARSNER",
        "authorized_official_first_name": "CLAYTON",
        "authorized_official_title_or_position": "VP/COO",
        "authorized_official_telephone_number": "512-324-5846"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ascension Medical Group Providence Urgent Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lacy Lakeview, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2023; 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.