Mothers' Milk Bank at Austin

Primary specialty

Dietary ManagerTaxonomy code 132700000X

Legal business name

MOTHERS' MILK BANK AT AUSTIN

Practice address

5925 Dillard Circle
Austin, TX 78752

Phone

(512) 494-0800

Fax

(512) 494-0880

NPI assigned

Mar 13, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Kimberly Updegrove, CNM, MPH, MSN

Title

Executive Director

Phone

(512) 494-0800

Specialties & licenses 3

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616976000000",
    "number": "1154454833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5925 DILLARD CIRCLE",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "78752",
            "telephone_number": "512-494-0800",
            "fax_number": "512-494-0880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5925 DILLARD CIRCLE",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "78752",
            "telephone_number": "512-494-0800",
            "fax_number": "512-494-0880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOTHERS' MILK BANK AT AUSTIN",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-13",
        "last_updated": "2021-03-29",
        "certification_date": "2021-03-29",
        "status": "A",
        "authorized_official_last_name": "UPDEGROVE",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "512-494-0800",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CNM, MPH, MSN"
    },
    "taxonomies": [
        {
            "code": "132700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietary Manager",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251V00000X",
            "taxonomy_group": "",
            "desc": "Voluntary or Charitable",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0057887-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Dietary Manager in Austin, TX
• Providers in Austin, TX by specialty
• Dietary Manager in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2021; 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.