Active NPI
Jeffrey Wade Hutchinson, M.D.
- Pediatric Adolescent Medicine Physician
- Austin, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Adolescent Medicine Physician
- License
- R8914
- Practice address
- 1101 Camino la Costa
Austin, TX 78752-3930 - Phone
- (512) 684-1832
- NPI assigned
- Aug 16, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Adolescent Medicine Physician | 2080A0000X | MD9244 | HI | |
| Pediatric Adolescent Medicine Physician | 2080A0000X | R8914 | TX | Primary |
Addresses
Primary practice location
1101 Camino la Costa
Austin, TX 78752-3930
Mailing address
1101 Camino la Costa
Austin, TX 78752-3930
Phone (512) 684-1832
Other practice location 1
Nnmc, Adolescent Department
8901 Wisconsin Ave
Bethesda, MD 20889-0001
Phone (301) 295-6168
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 766253 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD9244 | HI | MD | Pediatric Adolescent Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Peoples Community Clinic Inc | Current | Accepting new patients | |
| People'S Community Clinic, Inc. | Current | Accepting new patients |
Locations
1101 Camino La Costa
Austin, TX 78752
Phone (512) 478-4939
10335 US Highway 290 E
Manor, TX 78653
Phone (512) 278-4400
10335 US Highway 290 E
Bldg 35
Manor, TX 78653
Phone (512) 478-4939
Interoperability endpoints
- jhutchinson668522@direct.ochin.org
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Clinic/Center
- Austin, TX
- NPI 1598896391
-
- Federally Qualified Health Center (FQHC)
- Manor, TX
- NPI 1083019905
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124150400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1550793600000",
"number": "1477545408",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1101 CAMINO LA COSTA",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787523930",
"telephone_number": "512-684-1832"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1101 CAMINO LA COSTA",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787523930",
"telephone_number": "512-684-1832"
}
],
"practiceLocations": [
{
"address_1": "Nnmc, Adolescent Department",
"address_2": "8901 Wisconsin Ave",
"address_purpose": "LOCATION",
"city": "Bethesda",
"state": "MD",
"postal_code": "208890001",
"country_code": "US",
"telephone_number": "301-295-6168",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HUTCHINSON",
"first_name": "JEFFREY",
"middle_name": "WADE",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-16",
"last_updated": "2019-02-22",
"status": "A"
},
"taxonomies": [
{
"code": "2080A0000X",
"taxonomy_group": "",
"desc": "Pediatrics, Adolescent Medicine",
"state": "HI",
"license": "MD9244",
"primary": false
},
{
"code": "2080A0000X",
"taxonomy_group": "",
"desc": "Pediatrics, Adolescent Medicine",
"state": "TX",
"license": "R8914",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "766253",
"state": "TX"
}
],
"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 Feb 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.