Active NPI
Austin Diagnostic Clinic, PA
- Physical Therapist
- Austin, TX
National Provider Identifier
1013981182
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Legal business name
- AUSTIN DIAGNOSTIC CLINIC, PA
- Practice address
- 12221 Mo Pac Expwy North
Dept of Physical Therapy
Austin, TX 78758-2483 - Phone
- (512) 901-4402
- Fax
- (512) 901-4103
- NPI assigned
- Feb 15, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ellen M Andrew
- Title
- Credentialing Specialist
- Phone
- (512) 901-4937
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | Primary | ||
| Occupational Therapist | 225X00000X |
Addresses
Primary practice location
12221 Mo Pac Expwy North
Dept of Physical Therapy
Austin, TX 78758-2483
Mailing address
12221 Mo Pac Expwy North
Dept of Physical Therapy
Austin, TX 78758-2483
Phone (512) 901-4402
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 140347946 | Medicaid | TX |
Other names 1
- Austin Diagnostic Clinic
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139961600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1256083200000",
"number": "1013981182",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12221 MO PAC EXPWY NORTH",
"address_2": "DEPT OF PHYSICAL THERAPY",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787582483",
"telephone_number": "512-901-4402",
"fax_number": "512-901-4103"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12221 MO PAC EXPWY NORTH",
"address_2": "DEPT OF PHYSICAL THERAPY",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787582483",
"telephone_number": "512-901-4402",
"fax_number": "512-901-4103"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "AUSTIN DIAGNOSTIC CLINIC, PA",
"organizational_subpart": "NO",
"enumeration_date": "2006-02-15",
"last_updated": "2009-10-21",
"status": "A",
"authorized_official_last_name": "ANDREW",
"authorized_official_first_name": "ELLEN",
"authorized_official_middle_name": "M",
"authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
"authorized_official_telephone_number": "512-901-4937"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": true
},
{
"code": "225X00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Occupational Therapist",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "140347946",
"state": "TX"
}
],
"endpoints": [],
"other_names": [
{
"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 Oct 21, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.