NPIMap

Organization Active NPI

Bluebonnet Trails Community MHMR Center

  • Case Manager/Care Coordinator
  • Round Rock, TX
National Provider Identifier
1023150877
Registry record updated Aug 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
License
NO LICENSE Issued in TX
Legal business name
BLUEBONNET TRAILS COMMUNITY MHMR CENTER
Practice address
1009 N Georgetown St
Round Rock, TX 78664-3289
Phone
(512) 255-1720
Fax
(512) 244-8371
NPI assigned
Feb 12, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2023

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

Authorized official

Name
Ms. Noralisa Williams
Title
Credentialing Coordinator
Phone
(512) 244-8374

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163WP0808X NO LICENSE TX
Adult Psychiatric/Mental Health Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163WP0809X NO LICESE TX
Licensed Vocational NurseGroup: 193200000X MULTI-SPECIALTY GROUP 164X00000X NO LICENSE TX
Case Manager/Care CoordinatorGroup: 193200000X MULTI-SPECIALTY GROUP 171M00000X NO LICENSE TX Primary
InterpreterGroup: 193200000X MULTI-SPECIALTY GROUP 171R00000X NO LICENSE TX
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X NO LICENSE TX
Adult Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LA2200X NO LICENSE TX
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X NO LICENSE TX

Addresses

Primary practice location

1009 N Georgetown St
Round Rock, TX 78664-3289

Mailing address

1009 N Georgetown St
Round Rock, TX 78664-3289
Phone (512) 255-1720

Other identifiers 4

IdentifierTypeStateIssuer
1268443 05MedicaidTX
1268443 02MedicaidTX
0197201 01MedicaidTX
1268443 04MedicaidTX

National Provider Directory

National Provider Directory
Tax ID family
Bluebonnet Trails MHMR Center9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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": "1171238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693180800000",
    "number": "1023150877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1009 N GEORGETOWN ST",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786643289",
            "telephone_number": "512-255-1720",
            "fax_number": "512-244-8371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1009 N GEORGETOWN ST",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786643289",
            "telephone_number": "512-255-1720",
            "fax_number": "512-244-8371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUEBONNET TRAILS COMMUNITY MHMR CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-12",
        "last_updated": "2023-08-28",
        "certification_date": "2023-08-28",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "NORALISA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "512-244-8374",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "TX",
            "license": "NO LICENSE",
            "primary": false
        },
        {
            "code": "163WP0809X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "TX",
            "license": "NO LICESE",
            "primary": false
        },
        {
            "code": "164X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Licensed Vocational Nurse",
            "state": "TX",
            "license": "NO LICENSE",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": "TX",
            "license": "NO LICENSE",
            "primary": true
        },
        {
            "code": "171R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Interpreter",
            "state": "TX",
            "license": "NO LICENSE",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "NO LICENSE",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "TX",
            "license": "NO LICENSE",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "NO LICENSE",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1268443 05",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1268443 02",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0197201 01",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1268443 04",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Round Rock, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 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.