NPIMap

Organization Active NPI

Jepson Medical Affiliates PA

Doing business as Integrative Sports and Wellness Medical Center

  • Sports Medicine (Emergency Medicine) Physician
  • Austin, TX
National Provider Identifier
1396060711
Registry record updated Mar 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Emergency Medicine) PhysicianTaxonomy code 207PS0010X
Legal business name
JEPSON MEDICAL AFFILIATES PA
Doing business as
Integrative Sports and Wellness Medical Center
Practice address
11420 FM 2244
Suite a-100
Austin, TX 78738-5526
Phone
(512) 263-9961
Fax
(512) 263-9963
NPI assigned
Mar 29, 2010
Last updated
Mar 30, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2010

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

Authorized official

Name
Dr. Bryan Jepson, M.D.NPI 1194868109
Title
President
Phone
(512) 263-9961

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physician Chiropractor 111NS0005X NU
Sports Medicine (Emergency Medicine) Physician 207PS0010X NU Primary
Sports Medicine (Physical Medicine & Rehabilitation) Physician 2081S0010X NU

Addresses

Primary practice location

11420 FM 2244
Suite a-100
Austin, TX 78738-5526

Mailing address

11420 FM 2244
Suite a-100
Austin, TX 78738-5526
Phone (512) 263-9961

Other names 1

  • Integrative Sports and Wellness Medical Center Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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": "1269820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1269907200000",
    "number": "1396060711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11420 FM 2244",
            "address_2": "SUITE A-100",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787385526",
            "telephone_number": "512-263-9961",
            "fax_number": "512-263-9963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11420 FM 2244",
            "address_2": "SUITE A-100",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787385526",
            "telephone_number": "512-263-9961",
            "fax_number": "512-263-9963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEPSON MEDICAL AFFILIATES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-29",
        "last_updated": "2010-03-30",
        "status": "A",
        "authorized_official_last_name": "JEPSON",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "512-263-9961",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207PS0010X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Sports Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Integrative Sports and Wellness Medical 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 Mar 30, 2010; 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.