Organization Active NPI

Mystic Waters LLC

  • Obstetrics Physician
  • Austin, TX
National Provider Identifier
1225824030
Registry record updated Apr 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics PhysicianTaxonomy code 207VX0000X
Legal business name
MYSTIC WATERS LLC
Practice address
14523 Ridgetop Ter
Austin, TX 78732-1037
Phone
(760) 815-6923
NPI assigned
Apr 17, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2025

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

Authorized official

Name
Yolande Rademeyer, LMNPI 1407448335
Title
Midwife/Owner
Phone
(760) 815-6923

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207VX0000X Primary

Addresses

Primary practice location

14523 Ridgetop Ter
Austin, TX 78732-1037

Mailing address

14523 Ridgetop Ter
Austin, TX 78732-1037
Phone (760) 815-6923

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1744848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744848000000",
    "number": "1225824030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14523 RIDGETOP TER",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787321037",
            "telephone_number": "760-815-6923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14523 RIDGETOP TER",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787321037",
            "telephone_number": "760-815-6923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MYSTIC WATERS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-17",
        "last_updated": "2025-04-17",
        "certification_date": "2025-04-17",
        "status": "A",
        "authorized_official_last_name": "RADEMEYER",
        "authorized_official_first_name": "YOLANDE",
        "authorized_official_title_or_position": "MIDWIFE/OWNER",
        "authorized_official_telephone_number": "760-815-6923",
        "authorized_official_credential": "LM"
    },
    "taxonomies": [
        {
            "code": "207VX0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Apr 17, 2025; 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.