Rockdale Blackhawk LLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

ROCKDALE BLACKHAWK LLC

Doing business as

Little River Healthcare Westlake Clinic

Practice address

5656 Bee Cave Rd
Suite M-300
West Lake Hills, TX 78746-5280

Phone

(512) 807-3270

Fax

(512) 807-3328

NPI assigned

Mar 7, 2012

Last updated

May 14, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jeffrey P Madison

Title

Ceo

Phone

(512) 446-4500

Specialties & licenses 1

Addresses

Other names 1

• Little River Healthcare Westlake Clinic Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Carmelo C Otero, PA

  • Physician Assistant
  • West Lake Hills, TX
  • NPI 1194716647
  NPD (past)

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

{
    "created_epoch": "1331078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431561600000",
    "number": "1033483086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1010",
            "city": "ROCKDALE",
            "state": "TX",
            "postal_code": "765671010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5656 BEE CAVE RD",
            "address_2": "SUITE M-300",
            "city": "WEST LAKE HILLS",
            "state": "TX",
            "postal_code": "787465280",
            "telephone_number": "512-807-3270",
            "fax_number": "512-807-3328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROCKDALE BLACKHAWK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-07",
        "last_updated": "2015-05-14",
        "status": "A",
        "authorized_official_last_name": "MADISON",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "512-446-4500"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Little River Healthcare Westlake Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• George Pete Rivers, LPC
• Robert M Mingea III
• Robert P Wills MD PLLC (Austin Pain Associates)
• Casey Robinson, OTR
• Marshalla Ann Robinson, LMT
• Nikki Rodriguez
• Chloe Faith Rogers, LMSW
• Ellen Louise Rohr, LPC
• Karen Alejandra Rojas, BCAT
• Veronica Ellen Roth, LCSW

• General Practice Physician in West Lake Hills, TX
• Providers in West Lake Hills, TX by specialty
• General Practice Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2015; 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.