NPIMap

Organization Active NPI

RC Raley Professional Association

  • Family Medicine Physician
  • Austin, TX
National Provider Identifier
1407168552
Registry record updated Apr 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
RC RALEY PROFESSIONAL ASSOCIATION
Practice address
2301 W North Loop Blvd
Austin, TX 78756-2326
Phone
(512) 452-2506
NPI assigned
Jul 6, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2024

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

Authorized official

Name
Robert C Raley, M.D.NPI 1154460590
Title
President
Phone
(512) 452-2506

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
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Adult Health Clinical Nurse SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 364SA2200X

Addresses

Primary practice location

2301 W North Loop Blvd
Austin, TX 78756-2326

Mailing address

807 Stark St
Austin, TX 78756-1508
Phone (512) 452-2506

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101111000903 TX Part B Supplier - Clinic/Group Practice 7214122555 Receives reassigned benefits from 2 practitioners
Practice locations: Austin, TX

National Provider Directory

National Provider Directory

Locations

807 Stark St
Austin, TX 78756
Phone (512) 452-2506

Practitioners & affiliated clinicians

Practitioners 8

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

NPI Registry JSON

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

{
    "created_epoch": "1278374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712102400000",
    "number": "1407168552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "807 STARK ST",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787561508",
            "telephone_number": "512-452-2506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 W NORTH LOOP BLVD",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787562326",
            "telephone_number": "512-452-2506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RC RALEY PROFESSIONAL ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-06",
        "last_updated": "2024-04-03",
        "certification_date": "2024-04-03",
        "status": "A",
        "authorized_official_last_name": "RALEY",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "512-452-2506",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "364SA2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Nurse Specialist, Adult Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Apr 3, 2024; 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.