NPIMap

Organization Active NPI

Blackhawk Physician Group

  • General Practice Physician
  • Rockdale, TX
National Provider Identifier
1609021765
Registry record updated Nov 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
BLACKHAWK PHYSICIAN GROUP
Practice address
1700 Brazos Ave
Rockdale, TX 76567-2517
Phone
(512) 446-4502
NPI assigned
Nov 17, 2008
Last updated
Nov 17, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
BLACKHAWK HEALTHCARE, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 17, 2008

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

Authorized official

Name
Todd Biederman
Title
President/Ceo
Phone
(512) 681-3440

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

1700 Brazos Ave
Rockdale, TX 76567-2517

Mailing address

6500 River Place Blvd
Building 1, Suite 350
Austin, TX 78730-1119
Phone (512) 681-3440

National Provider Directory

National Provider Directory

Locations

6500 River Place Blvd
Bldg 1
Austin, TX 78730

6500 River Place Blvd
Ste 350
Austin, TX 78730

Practitioners & affiliated clinicians

Practitioners 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1226880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1226880000000",
    "number": "1609021765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6500 RIVER PLACE BLVD",
            "address_2": "BUILDING 1, SUITE 350",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787301119",
            "telephone_number": "512-681-3440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 BRAZOS AVE",
            "city": "ROCKDALE",
            "state": "TX",
            "postal_code": "765672517",
            "telephone_number": "512-446-4502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLACKHAWK PHYSICIAN GROUP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BLACKHAWK HEALTHCARE, LLC",
        "enumeration_date": "2008-11-17",
        "last_updated": "2008-11-17",
        "status": "A",
        "authorized_official_last_name": "BIEDERMAN",
        "authorized_official_first_name": "TODD",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "512-681-3440"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockdale, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2008; 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.