NPIMap

Organization Active NPI

Privia Medical Group Gulf Coast, PLLC

Doing business as Shine Foot and Ankle Center, PLLC

  • Podiatrist
  • Austin, TX
National Provider Identifier
1437880002
Registry record updated Jul 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
PRIVIA MEDICAL GROUP GULF COAST, PLLC
Doing business as
Shine Foot and Ankle Center, PLLC
Practice address
3901 Medical Pkwy Ste 301
Austin, TX 78756-4022
Phone
(512) 399-5711
NPI assigned
Jun 23, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2022

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

Authorized official

Name
Barbara Jordan
Title
Authorized Official
Phone
(713) 512-7613

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X Primary

Addresses

Primary practice location

3901 Medical Pkwy Ste 301
Austin, TX 78756-4022

Mailing address

1200 Binz St Ste 1490
Houston, TX 77004-6946
Phone (713) 512-7700

Other names 1

  • Shine Foot and Ankle Center, PLLC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Southwest Womens HLTH Allia21 organizations share this tax ID, including this one

Other organizations with this tax ID 20

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

View all 20

Locations

3901 Medical Pkwy
Ste 301
Austin, TX 78756
Phone (512) 458-3279

NPI Registry JSON

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

{
    "created_epoch": "1655942400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657152000000",
    "number": "1437880002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 BINZ ST STE 1490",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770046946",
            "telephone_number": "713-512-7700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 MEDICAL PKWY STE 301",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787564022",
            "telephone_number": "512-399-5711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIVIA MEDICAL GROUP GULF COAST, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-23",
        "last_updated": "2022-07-07",
        "certification_date": "2022-07-07",
        "status": "A",
        "authorized_official_last_name": "JORDAN",
        "authorized_official_first_name": "BARBARA",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "713-512-7613"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shine Foot and Ankle Center, PLLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Shine Foot and Ankle Center, PLLC",
            "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 Jul 7, 2022; 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.