Organization Active NPI

Ambulatory Adult Neurology, PA

  • Neurology Physician
  • Corpus Christi, TX
National Provider Identifier
1689872269
Registry record updated Jan 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
H2754 Issued in TX
Legal business name
AMBULATORY ADULT NEUROLOGY, PA
Practice address
5402 Holly Road
Suite 2102
Corpus Christi, TX 78411
Phone
(361) 882-9100
Fax
(361) 882-9194
NPI assigned
Jul 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2014

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

Authorized official

Name
Dr. Juan Felipe Santos, M.D.NPI 1376508101
Title
President
Phone
(361) 882-9100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084N0400X H2754 TX Primary

Addresses

Primary practice location

5402 Holly Road
Suite 2102
Corpus Christi, TX 78411

Mailing address

5402 Holly Road
Suite 2102
Corpus Christi, TX 78411
Phone (361) 882-9100

Other identifiers 1

IdentifierTypeStateIssuer
148759701MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110323000464 TX Part B Supplier - Clinic/Group Practice 1052594405 Receives reassigned benefits from 1 practitioner
Practice locations: Corpus Christi, TX

National Provider Directory

National Provider Directory

Locations

527 Gordon St
Ste B
Corpus Christi, TX 78404
Phone (361) 882-9100

2601 Hospital Blvd
Ste 206
Corpus Christi, TX 78405
Phone (361) 882-9100

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1183593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1390953600000",
    "number": "1689872269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5402 HOLLY ROAD",
            "address_2": "SUITE 2102",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "78411",
            "telephone_number": "361-882-9100",
            "fax_number": "361-882-9194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5402 HOLLY ROAD",
            "address_2": "SUITE 2102",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "78411",
            "telephone_number": "361-882-9100",
            "fax_number": "361-882-9194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMBULATORY ADULT NEUROLOGY, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-05",
        "last_updated": "2014-01-29",
        "status": "A",
        "authorized_official_last_name": "SANTOS",
        "authorized_official_first_name": "JUAN",
        "authorized_official_middle_name": "FELIPE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "361-882-9100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "TX",
            "license": "H2754",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "148759701",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Corpus Christi, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.