Individual provider Active NPI

Jack E Horton, MD

  • Pediatrics Physician
  • Austin, TX
National Provider Identifier
1689680951
Registry record updated Dec 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
J2087 Issued in TX
Practice address
1807 W Slaughter LN
#490
Austin, TX 78748-6208
Phone
(512) 282-8967
Fax
(512) 292-5143
NPI assigned
Jul 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X J2087 TX Primary

Addresses

Primary practice location

1807 W Slaughter LN
#490
Austin, TX 78748-6208

Mailing address

PO Box 26726
Austin, TX 78755-0726
Phone (512) 407-8686

Other identifiers 4

IdentifierTypeStateIssuer
116361004MedicaidTX
116361005MedicaidTX
116361002MedicaidTX
116361006MedicaidTX

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071127000724 TX Practitioner - Pediatric Medicine 2668561788 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
University of Texas Southwestern Medical School at Dallas, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Austin Regional Clinic PAGroup PAC ID 3072507789, 398 clinicians

Practice addresses (Care Compare)

1807 W Slaughter LN
490 Arc Southwest
Austin, TX 78748-6208
Phone (512) 282-8967

6835 Austin Ctr Blvd
Austin, TX 78731-3166
Phone (512) 346-6611

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Austin Regional Clinic, PA CurrentSince Nov 16, 2010 Accepting new patients
Austin Regional Clinic, PA Pediatrics CurrentSince Nov 16, 2010 Accepting new patients
Austin Regional Clinic, PA Past Accepting new patients

Locations

6835 Austin Center Blvd
Austin, TX 78731
Phone (512) 231-5210

6210 E Highway 290
Ste 420
Austin, TX 78723
Phone (512) 338-3802

1807 W Slaughter Ln
Ste 490
Austin, TX 78748
Phone (512) 282-8967

151 Exchange Blvd
Ste 500
Hutto, TX 78634
Phone (512) 846-1244

Interoperability endpoints

  • Direct secure messaging: jhorton3308@arcmd.direct-ci.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323993600000",
    "number": "1689680951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26726",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787550726",
            "telephone_number": "512-407-8686",
            "fax_number": "512-406-6216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1807 W SLAUGHTER LN",
            "address_2": "#490",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787486208",
            "telephone_number": "512-282-8967",
            "fax_number": "512-292-5143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HORTON",
        "first_name": "JACK",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2011-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "J2087",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "116361004",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "116361005",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "116361002",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "116361006",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.