Wildflower Pediatrics, PA

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MM4044 Issued in TX

Legal business name

WILDFLOWER PEDIATRICS, PA

Practice address

11609 Anderson Mill Rd
Austin, TX 78750-1354

Phone

(512) 900-6055

Fax

(512) 900-6056

NPI assigned

Apr 21, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Courtney Dudley, MDNPI 1144242173

Title

President

Phone

(512) 900-6055

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/15935/brand/1/csg/1/fhir/r4

Practitioners 5

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

• Courtney Relyea Dudley, MD

  • Pediatrics Physician
  • Austin, TX
  • NPI 1144242173
  NPD (past) Authorized official
• Karl Wilhelm Kurz, MD

  • Pediatrics Physician
  • Dallas, TX
  • NPI 1134461999
  NPD (past)
• Rachael Lichtenberger, PA-C

  • Medical Physician Assistant
  • Austin, TX
  • NPI 1912309675
  NPD (past)
• Amber Presson Rogers, MD

  • Pediatrics Physician
  • Austin, TX
  • NPI 1245537406
  NPD (past)
• Meghan Wheeler, APRN

  • Pediatric Nurse Practitioner
  • Austin, TX
  • NPI 1336874239

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1492732800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492732800000",
    "number": "1639604184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11609 ANDERSON MILL RD",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787501354",
            "telephone_number": "512-900-6055",
            "fax_number": "512-900-6056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11609 ANDERSON MILL RD",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787501354",
            "telephone_number": "512-900-6055",
            "fax_number": "512-900-6056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILDFLOWER PEDIATRICS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-21",
        "last_updated": "2017-04-21",
        "status": "A",
        "authorized_official_last_name": "DUDLEY",
        "authorized_official_first_name": "COURTNEY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "512-900-6055",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "MM4044",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrea Wilder
• Justin Wilder, RN
• Katharina Ingeborg Leonore Wilder, APRN-C
• Olivia Jo Wilder, ANP
• Tyler Craig Wildey, DDS
• Wildflower Psychotherapy PLLC
• Lindsey Wiley
• Sarah Elizabeth Wiley
• Corby Wilfley
• Katherine Wilford

• Pediatrics Physician in Austin, TX
• Providers in Austin, TX by specialty
• Pediatrics Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.