Rockdale Blackhawk LLC

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

License

000369 Issued in TX

Legal business name

ROCKDALE BLACKHAWK LLC

Doing business as

Little River Healthcare Rockdale Clinic

Practice address

602 N Main St
Rockdale, TX 76567-2323

Phone

(512) 446-4500

Fax

(512) 446-0084

NPI assigned

Jul 25, 2006

Last updated

Feb 11, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jeffrey P Madison

Title

Ceo

Phone

(512) 446-4500

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Little River Healthcare Rockdale Clinic Doing business as

Locations

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423612800000",
    "number": "1699798512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1010",
            "city": "ROCKDALE",
            "state": "TX",
            "postal_code": "765671010",
            "telephone_number": "512-446-4500",
            "fax_number": "512-446-0084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 N MAIN ST",
            "city": "ROCKDALE",
            "state": "TX",
            "postal_code": "765672323",
            "telephone_number": "512-446-4500",
            "fax_number": "512-446-0084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROCKDALE BLACKHAWK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-25",
        "last_updated": "2015-02-11",
        "status": "A",
        "authorized_official_last_name": "MADISON",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "512-446-4500"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "TX",
            "license": "000369",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111705303",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Little River Healthcare Rockdale Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Regina Robertson (A Nurse's Touch Home Health)
• Rockdale Blackhawk LLC (Little River Medical Clinic - Rockdale)
• Rockdale Blackhawk LLC (Richards Memorial Hospital)
• Rockdale Blackhawk LLC (Little River Healthcare)
• Rockdale Blackhawk LLC (Family Care Center)
• Rockdale Blackhawk, LLC (LIttle River Healthcare - Family Care Center)
• Rockdale Blackhawk, LLC (Little River Healthcare)
• Rockdale Dental PLLC
• Rockdale Hospital District
• Rockdale Independent School District

• Rural Health Clinic/Center in Rockdale, TX
• Providers in Rockdale, TX by specialty
• Rural Health Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2015; 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.