NPIMap

Organization Active NPI

Rockdale Blackhawk,LLC

  • Orthopaedic Surgery Physician
  • Killeen, TX
National Provider Identifier
1346791027
Registry record updated Oct 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
ROCKDALE BLACKHAWK,LLC
Practice address
401 W Jasper Dr
Killeen, TX 76542-1323
Phone
(254) 519-1313
NPI assigned
Oct 18, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2016

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

Authorized official

Name
Jeffrey P Madison
Title
Ceo
Phone
(512) 446-4500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207X00000X Primary

Addresses

Primary practice location

401 W Jasper Dr
Killeen, TX 76542-1323

Mailing address

1 Chisholm TRL
Suite 400
Round Rock, TX 78681-5008
Phone (512) 481-7060

Other names 1

  • Little River Healthcare Killeen Clinic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Rockdale Blackhawk LLC15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

Organizations that report the same tax identification number in the National Provider Directory.

View all 14

Locations

1 Chisholm Trail Rd
Ste 400
Round Rock, TX 78681
Phone (512) 464-6862

NPI Registry JSON

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

{
    "created_epoch": "1476748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476748800000",
    "number": "1346791027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CHISHOLM TRL",
            "address_2": "SUITE 400",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786815008",
            "telephone_number": "512-481-7060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 W JASPER DR",
            "city": "KILLEEN",
            "state": "TX",
            "postal_code": "765421323",
            "telephone_number": "254-519-1313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROCKDALE BLACKHAWK,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-18",
        "last_updated": "2016-10-18",
        "status": "A",
        "authorized_official_last_name": "MADISON",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "512-446-4500"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Little River Healthcare Killeen Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Killeen, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2016; 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.