NPIMap

Organization Active NPI

South Austin Orthopaedic Clinic PA

  • Specialist
  • Austin, TX
National Provider Identifier
1073611992
Registry record updated Dec 18, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
SOUTH AUSTIN ORTHOPAEDIC CLINIC PA
Practice address
4534 W Gate Blvd
Suite 110
Austin, TX 78745-1485
Phone
(512) 892-1220
NPI assigned
Sep 21, 2006
Last updated
Dec 18, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2009

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

Authorized official

Name
Dr. Clark Race, MD
Title
President
Phone
(512) 892-1220

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X NU Primary

Addresses

Primary practice location

4534 W Gate Blvd
Suite 110
Austin, TX 78745-1485

Mailing address

4534 W Gate Blvd
Suite 110
Austin, TX 78745-1485
Phone (512) 892-1220

Other identifiers 1

IdentifierTypeStateIssuer
141613301MedicaidTX

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

4534 West Gate Blvd
Ste 110
Austin, TX 78745
Phone (512) 892-1220

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1261094400000",
    "number": "1073611992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4534 W GATE BLVD",
            "address_2": "SUITE 110",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787451485",
            "telephone_number": "512-892-1220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4534 W GATE BLVD",
            "address_2": "SUITE 110",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787451485",
            "telephone_number": "512-892-1220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH AUSTIN ORTHOPAEDIC CLINIC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-21",
        "last_updated": "2009-12-18",
        "status": "A",
        "authorized_official_last_name": "RACE",
        "authorized_official_first_name": "CLARK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "512-892-1220",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "141613301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Dec 18, 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.

Verify at the official NPI Registry.