Central River Healthcare Group, PLLC

Primary specialty

Sports Medicine (Emergency Medicine) PhysicianTaxonomy code 207PS0010X

License

L1765 Issued in TX

Legal business name

CENTRAL RIVER HEALTHCARE GROUP, PLLC

Practice address

1918 E Riverside Dr
South Austin Medical & Health Clinic
Austin, TX 78741-1323

Phone

(512) 326-9200

NPI assigned

Nov 1, 2006

Organization subpart

No

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

Authorized official

Name

Loann The Trinh, D.O.NPI 1548240799

Title

President/Medical Director

Phone

(512) 326-9200

Specialties & licenses 8

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 8

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

• Loann T Trinh, D.O.

  • General Practice Physician
  • Austin, TX
  • NPI 1548240799

  Sports Medicine

  Medicare reassignment NPD Authorized official
• Tony Dang, M.D.

  • Family Medicine Physician
  • Austin, TX
  • NPI 1083795199
  Medicare reassignment NPD
• Gerald Paul Heisler, M.D.

  • Family Medicine Physician
  • Houston, TX
  • NPI 1245310168
  NPD (past)
• Padmaja Abhang Naik, MD

  • Family Medicine Physician
  • Austin, TX
  • NPI 1659554186
  NPD (past)
• Liesl Christine Schott, M.D.

  • General Practice Physician
  • San Antonio, TX
  • NPI 1649376336
  NPD (past)
• Khiem Huong Trinh, D.C.

  • Chiropractor
  • Austin, TX
  • NPI 1821194457
  NPD (past)
• Gloria Marroquin, M.D.

  • Public Health & General Preventive Medicine Physician
  • Scottsville, KY
  • NPI 1053365478

  Family Medicine

  NPD (past)
• Pedro Alberto Mendoza, AGACNP

  • Nurse Practitioner
  • Cody, WY
  • NPI 1861769598
  NPD (past)

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334102400000",
    "number": "1295813764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8557 RESEARCH BLVD STE 128",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787587855",
            "telephone_number": "512-326-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1918 E RIVERSIDE DR",
            "address_2": "SOUTH AUSTIN MEDICAL & HEALTH CLINIC",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787411323",
            "telephone_number": "512-326-9200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL RIVER HEALTHCARE GROUP, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2012-04-11",
        "status": "A",
        "authorized_official_last_name": "TRINH",
        "authorized_official_first_name": "LOANN",
        "authorized_official_middle_name": "THE",
        "authorized_official_title_or_position": "PRESIDENT/MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "512-326-9200",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "8016",
            "primary": false
        },
        {
            "code": "207PS0010X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine, Sports Medicine",
            "state": "TX",
            "license": "L1765",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "M7463",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "M5120",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "H4396",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Sports Medicine",
            "state": "TX",
            "license": "L1765",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "L1765",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "TX",
            "license": "M2793",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "161008101",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF TEXAS",
            "identifier": "00553V",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Central Austin Surgical PA Partners PLLC
• Central Chiropractic Center
• Central Family Dental Center
• Central Park Associates of Radiology LLC
• Central Park Imaging Center, LTD.
• Central Texas
• Central Texas Anesthesia Partners PLLC
• Central Texas Assists, PLLC
• Central Texas Audiology & Hearing AIDS, LLC
• Central Texas Autism Center

• Sports Medicine (Emergency Medicine) Physician in Austin, TX
• Providers in Austin, TX by specialty
• Sports Medicine (Emergency Medicine) Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2012; 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.