NPIMap

Organization Active NPI

Medley Swim Systems Inc

Doing business as Lakeway Aquatic Therapy & Wellness Center

  • Physical Therapist
  • Austin, TX
National Provider Identifier
1285676528
Registry record updated Jul 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
MEDLEY SWIM SYSTEMS INC
Doing business as
Lakeway Aquatic Therapy & Wellness Center
Practice address
1927 Lohmans Crossing Rd
Suite 100
Austin, TX 78734-5239
Phone
(512) 261-0620
Fax
(512) 261-9441
NPI assigned
Jun 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2013

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

Authorized official

Name
Mr. Barker F Keith II
Title
Administrator
Phone
(512) 261-0620

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

1927 Lohmans Crossing Rd
Suite 100
Austin, TX 78734-5239

Mailing address

PO Box 342348
Austin, TX 78734-0040
Phone (512) 261-0620

Other names 1

  • Lakeway Aquatic Therapy & Wellness Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041207000564 TX Part B Supplier - Physical/Occupational Therapy Group in Private Practice 9931165461 Receives reassigned benefits from 3 practitioners
Practice locations: Lakeway, TX

National Provider Directory

National Provider Directory

Locations

900 Ranch Road 620 S
Ste A103
Lakeway, TX 78734
Phone (512) 261-0620

1927 Lohmans Crossing Rd
Ste 100
Lakeway, TX 78734
Phone (512) 261-0620

Practitioners & affiliated clinicians

Practitioners 9

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": "1150070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372809600000",
    "number": "1285676528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 342348",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787340040",
            "telephone_number": "512-261-0620",
            "fax_number": "512-261-9441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1927 LOHMANS CROSSING RD",
            "address_2": "SUITE 100",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787345239",
            "telephone_number": "512-261-0620",
            "fax_number": "512-261-9441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDLEY SWIM SYSTEMS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-12",
        "last_updated": "2013-07-03",
        "status": "A",
        "authorized_official_last_name": "KEITH",
        "authorized_official_first_name": "BARKER",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "512-261-0620",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "II"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lakeway Aquatic Therapy & Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jul 3, 2013; 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.