NPIMap

Organization Active NPI

South Austin Family Practice Clinic, PLLC

  • Family Medicine Physician
  • Austin, TX
National Provider Identifier
1235130592
Registry record updated Jun 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SOUTH AUSTIN FAMILY PRACTICE CLINIC, PLLC
Practice address
5625 Eiger Rd
Suite 200
Austin, TX 78735-8982
Phone
(512) 892-7076
Fax
(239) 599-2625
NPI assigned
Aug 9, 2005
Last updated
Jun 20, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2025

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

Authorized official

Name
Kevin P Spencer, M.D.NPI 1417996570
Title
President
Phone
(512) 892-7076

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary
Internal Medicine Physician 207R00000X
Pediatrics Physician 208000000X
Podiatrist 213E00000X

Addresses

Primary practice location

5625 Eiger Rd
Suite 200
Austin, TX 78735-8982

Mailing address

2675 Winkler Ave FL 2
Fort Myers, FL 33901-9342
Phone (877) 856-3774

Other practice location 1

3101 Highway 71 E Ste 101
Bastrop, TX 78602-5159
Phone (512) 304-0300

Other practice location 2

101 Medical Parkway
220
Lakeway, TX 78738-5621
Phone (512) 358-8180

Other practice location 3

170 Benney Ln Ste 200
Dripping Springs, TX 78620-5559
Phone (512) 892-7076

Other practice location 4

12600 Hill Country Blvd Bldg R-103
Austin, TX 78738-6891
Phone (512) 892-7076

Other practice location 5

912 S Capital Of Texas Hwy Ste 100
West Lake Hills, TX 78746-5242
Phone (512) 892-7076

Other practice location 6

2015 S Interstate 35 Ste 130
Austin, TX 78741-3810
Phone (512) 996-1466

Other identifiers 1

IdentifierTypeStateIssuer
1235130592OtherTXNPI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040520001500 TX Part B Supplier - Clinic/Group Practice 3678564358 Receives reassigned benefits from 85 practitioners
Practice locations: Austin, TX; Bastrop, TX; Dripping Springs, TX; Lakeway, TX; Smithville, TX; West Lake Hills, TX

National Provider Directory

National Provider Directory

Member organizations 1

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

Locations

2015 S Interstate 35
Ste 130
Austin, TX 78741
Phone (512) 996-1466

5625 Eiger Rd
Ste 2
Austin, TX 78735

11701 FM 2244 Rd
Ste 130
Bee Cave, TX 78738

12600 Hill Country Blvd
Bldg R-103
Bee Cave, TX 78738
Phone (512) 358-8180

170 Benney Ln
Ste 200
Dripping Springs, TX 78620
Phone (512) 858-2997

101 Medical Pkwy
Ste 210
Lakeway, TX 78738
Phone (512) 358-8180

200 Medical Pkwy
Ste 380
Lakeway, TX 78738
Phone (512) 206-2988

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Accentcare Hospice & Palliative Care - AustinAustin, TX, CCN 671554 Hospice 5% Or Greater Indirect Ownership Interest Feb 29, 2016

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 92

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.

View all 92

NPI Registry JSON

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750377600000",
    "number": "1235130592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2675 WINKLER AVE FL 2",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339019342",
            "telephone_number": "877-856-3774",
            "fax_number": "239-599-2625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5625 EIGER RD",
            "address_2": "SUITE 200",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787358982",
            "telephone_number": "512-892-7076",
            "fax_number": "239-599-2625"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3101 Highway 71 E Ste 101",
            "address_purpose": "LOCATION",
            "city": "Bastrop",
            "state": "TX",
            "postal_code": "786025159",
            "country_code": "US",
            "telephone_number": "512-304-0300",
            "fax_number": "855-270-9668",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "101 Medical Parkway",
            "address_2": "220",
            "address_purpose": "LOCATION",
            "city": "Lakeway",
            "state": "TX",
            "postal_code": "787385621",
            "country_code": "US",
            "telephone_number": "512-358-8180",
            "fax_number": "855-270-9668",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "170 Benney Ln Ste 200",
            "address_purpose": "LOCATION",
            "city": "Dripping Springs",
            "state": "TX",
            "postal_code": "786205559",
            "country_code": "US",
            "telephone_number": "512-892-7076",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12600 Hill Country Blvd Bldg R-103",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787386891",
            "country_code": "US",
            "telephone_number": "512-892-7076",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "912 S Capital Of Texas Hwy Ste 100",
            "address_purpose": "LOCATION",
            "city": "West Lake Hills",
            "state": "TX",
            "postal_code": "787465242",
            "country_code": "US",
            "telephone_number": "512-892-7076",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2015 S Interstate 35 Ste 130",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787413810",
            "country_code": "US",
            "telephone_number": "512-996-1466",
            "fax_number": "855-270-9668",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SOUTH AUSTIN FAMILY PRACTICE CLINIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-09",
        "last_updated": "2025-06-20",
        "certification_date": "2025-06-13",
        "status": "A",
        "authorized_official_last_name": "SPENCER",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "512-892-7076",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1235130592",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.