NPIMap

Organization Active NPI

Medical Park Orthopaedic Clinic

  • Orthopaedic Surgery Physician
  • Austin, TX
National Provider Identifier
1124057344
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
MEDICAL PARK ORTHOPAEDIC CLINIC
Practice address
1301 W 38TH St
Ste. 102
Austin, TX 78705-1000
Phone
(512) 454-4561
Fax
(512) 467-2906
NPI assigned
Jul 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. David W. Manning
Title
Administrator
Phone
(512) 454-4561

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207X00000X Primary

Addresses

Primary practice location

1301 W 38TH St
Ste. 102
Austin, TX 78705-1000

Mailing address

1301 W 38TH St
Ste. 102
Austin, TX 78705-1000
Phone (512) 454-4561

Other identifiers 3

IdentifierTypeStateIssuer
0587470001OtherTXPALMETTO GBA
CC8254OtherTXRAILROAD MEDICARE
00J744OtherTXBCBS

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1151712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1124057344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 W 38TH ST",
            "address_2": "STE. 102",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787051000",
            "telephone_number": "512-454-4561",
            "fax_number": "512-467-2906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 W 38TH ST",
            "address_2": "STE. 102",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787051000",
            "telephone_number": "512-454-4561",
            "fax_number": "512-467-2906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL PARK ORTHOPAEDIC CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MANNING",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "512-454-4561",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA",
            "identifier": "0587470001",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CC8254",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "00J744",
            "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 Aug 22, 2020; 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.