NPIMap

Organization Active NPI

Mary Lee Foundation

  • Clinic/Center
  • Austin, TX
National Provider Identifier
1083870778
Registry record updated Feb 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
MARY LEE FOUNDATION
Practice address
1339 Lamar Square Dr
Austin, TX 78704
Phone
(512) 443-1360
Fax
(512) 443-1758
NPI assigned
Aug 1, 2008
Last updated
Feb 25, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
MARY LEE FOUNDATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 25, 2020

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

Authorized official

Name
Charlene Crump
Title
Director
Phone
(512) 443-5777

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary
Rehabilitation Clinic/Center 261QR0400X

Addresses

Primary practice location

1339 Lamar Square Dr
Austin, TX 78704

Mailing address

1328 Lamar Square Dr.
Austin, TX 78704
Phone (512) 443-1360

Other names 1

  • Mary Lee Foundation Rehabilitation Center Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200318000859 TX Part B Supplier - Physical/Occupational Therapy Group in Private Practice 9436339140 Receives reassigned benefits from 6 practitioners
Practice locations: Austin, TX

National Provider Directory

National Provider Directory
Tax ID family
Mary Lee Foundation3 organizations share this tax ID, including this one
Part of
Mary Lee Foundation

Other organizations with this tax ID 2

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

Practitioners & affiliated clinicians

Practitioners 9

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": "1217548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582588800000",
    "number": "1083870778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1328 LAMAR SQUARE DR.",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "78704",
            "telephone_number": "512-443-1360",
            "fax_number": "512-443-1758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1339 LAMAR SQUARE DR",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "78704",
            "telephone_number": "512-443-1360",
            "fax_number": "512-443-1758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY LEE FOUNDATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MARY LEE FOUNDATION",
        "enumeration_date": "2008-08-01",
        "last_updated": "2020-02-25",
        "certification_date": "2020-02-25",
        "status": "A",
        "authorized_official_last_name": "CRUMP",
        "authorized_official_first_name": "CHARLENE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "512-443-5777"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mary Lee Foundation Rehabilitation Center",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Mary Lee Foundation Rehabilitation Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Feb 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.