Organization Active NPI

Neurology Clinic PA

  • Neurology Physician
  • Austin, TX
National Provider Identifier
1699190876
Registry record updated Feb 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
NEUROLOGY CLINIC PA
Practice address
601 W 17TH St
Austin, TX 78701-1103
Phone
(512) 708-9200
Fax
(512) 532-6261
NPI assigned
Feb 25, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2014

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

Authorized official

Name
Rebecca M Verellen, MDNPI 1336329903
Title
President
Phone
(512) 458-2600

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084N0400X Primary
Clinical Neurophysiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084N0600X

Addresses

Primary practice location

601 W 17TH St
Austin, TX 78701-1103

Mailing address

601 W 17TH St
Austin, TX 78701-1103
Phone (512) 708-9200

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141001002484 TX Part B Supplier - Clinic/Group Practice 6800016551 Receives reassigned benefits from 1 practitioner
Practice locations: Austin, TX

National Provider Directory

National Provider Directory

Locations

601 W 17th St
Austin, TX 78701
Phone (512) 708-9200

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": "1393286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1393286400000",
    "number": "1699190876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 W 17TH ST",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787011103",
            "telephone_number": "512-708-9200",
            "fax_number": "512-532-6261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 W 17TH ST",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787011103",
            "telephone_number": "512-708-9200",
            "fax_number": "512-532-6261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROLOGY CLINIC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-25",
        "last_updated": "2014-02-25",
        "status": "A",
        "authorized_official_last_name": "VERELLEN",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "512-458-2600",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084N0600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "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 25, 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.