Organization Active NPI

Dr. David Carmack PLLC

  • Podiatric Clinic/Center
  • Marble Falls, TX
National Provider Identifier
1326770967
Registry record updated Jan 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Podiatric Clinic/CenterTaxonomy code 261QP1100X
Legal business name
DR. DAVID CARMACK PLLC
Practice address
618 Broadway
Marble Falls, TX 78654
Phone
(830) 613-4457
NPI assigned
Jun 30, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2023

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

Authorized official

Name
Dr. David Lee Carmack, DPMNPI 1043212889
Title
Owner
Phone
(409) 550-2800

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213E00000X
Podiatric Clinic/Center 261QP1100X Primary

Addresses

Primary practice location

618 Broadway
Marble Falls, TX 78654

Mailing address

1107 FM 1431 Ste 105
Marble Falls, TX 78654-5006
Phone (830) 613-4457

Other identifiers 1

IdentifierTypeStateIssuer
8K8627MedicaidTX

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dcarmack@protonmail.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221107000162 TX Part B Supplier - Clinic/Group Practice 3274900154 Receives reassigned benefits from 1 practitioner
Practice locations: Marble Falls, TX

National Provider Directory

National Provider Directory

Locations

1107 Highway 1431
Marble Falls, TX 78654
Phone (512) 717-7833

618 Broadway St
Marble Falls, TX 78654
Phone (432) 294-4967

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1656547200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673481600000",
    "number": "1326770967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1107 FM 1431 STE 105",
            "city": "MARBLE FALLS",
            "state": "TX",
            "postal_code": "786545006",
            "telephone_number": "830-613-4457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "618 BROADWAY",
            "city": "MARBLE FALLS",
            "state": "TX",
            "postal_code": "78654",
            "telephone_number": "830-613-4457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. DAVID CARMACK PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-30",
        "last_updated": "2023-01-12",
        "certification_date": "2023-01-12",
        "status": "A",
        "authorized_official_last_name": "CARMACK",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "409-550-2800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8K8627",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dcarmack@protonmail.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1107 Fm 1431 Ste 105",
            "city": "Marble Falls",
            "state": "TX",
            "country_code": "US",
            "postal_code": "786545006",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Marble Falls, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2023; 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.