Rockdale Blackhawk LLC

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

ROCKDALE BLACKHAWK LLC

Doing business as

Little River Healthcare Cameron Clinic

Practice address

708 N Crockett Ave
Cameron, TX 76520-2551

Phone

(254) 697-6554

Fax

(254) 697-6643

NPI assigned

Apr 18, 2007

Last updated

Feb 11, 2015By the provider in NPPES

Organization subpart

No

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

Addresses

Other names 1

• Little River Healthcare Cameron Clinic Doing business as

Locations

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423612800000",
    "number": "1407072358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1010",
            "city": "ROCKDALE",
            "state": "TX",
            "postal_code": "765671010",
            "telephone_number": "512-446-4500",
            "fax_number": "512-446-0084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "708 N CROCKETT AVE",
            "city": "CAMERON",
            "state": "TX",
            "postal_code": "765202551",
            "telephone_number": "254-697-6554",
            "fax_number": "254-697-6643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROCKDALE BLACKHAWK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-18",
        "last_updated": "2015-02-11",
        "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": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Little River Healthcare Cameron Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Agbolade O. Odutayo, D.O.
• Onmed Professional Services PA
• Larry Scott Parker, DDS
• Paro Physician Services Inc.
• Denise Lourdes Pineda, COTA
• Sallymed, PLLC
• Robert Raney Schiller, RPH
• South Limestone Hospital District (Winnie L Nursing and Rehabilitation)
• Standard Regional Home Health Inc (Adaptive Home Health)
• Standards of Care, Inc. (Standards Home Health)

• Rural Health Clinic/Center in Cameron, TX
• Providers in Cameron, TX by specialty
• Rural Health Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2015; 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.