NPIMap

Organization Active NPI

Summit Mental Health Clinic PA

  • Clinic/Center
  • Austin, TX
National Provider Identifier
1699945360
Registry record updated Mar 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
L1620 Issued in TX
Legal business name
SUMMIT MENTAL HEALTH CLINIC PA
Doing business as
Summit Mental Health Clinic PA
Practice address
4131 Spicewood Springs Rd
BLDG#L, #2
Austin, TX 78759-8661
Phone
(512) 732-2122
NPI assigned
Mar 10, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2008

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

Authorized official

Name
Dr. Francisca Ada Ifesinachukwu, M.D.NPI 1558475335
Title
Medical Director/President
Phone
(512) 732-2122

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
Clinic/Center 261Q00000X L1620 TX Primary

Addresses

Primary practice location

4131 Spicewood Springs Rd
BLDG#L, #2
Austin, TX 78759-8661

Mailing address

PO Box 17906
Austin, TX 78760-7906
Phone (512) 732-2122

Other identifiers 3

IdentifierTypeStateIssuer
00773XOtherTXMEDICARE GROUP #
153758102MedicaidTX
173311501OtherTXTPI

Other names 1

  • Summit Mental Health Clinic PA Doing business as

National Provider Directory

National Provider Directory

Locations

4131 Spicewood Springs Rd
Bldg 2
Austin, TX 78759
Phone (512) 732-2122

4407 Bee Caves Rd
Ste 521
West Lake Hills, TX 78746
Phone (512) 940-9409

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1205107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205107200000",
    "number": "1699945360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 17906",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787607906",
            "telephone_number": "512-732-2122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4131 SPICEWOOD SPRINGS RD",
            "address_2": "BLDG#L, #2",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787598661",
            "telephone_number": "512-732-2122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT MENTAL HEALTH CLINIC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-10",
        "last_updated": "2008-03-10",
        "status": "A",
        "authorized_official_last_name": "IFESINACHUKWU",
        "authorized_official_first_name": "FRANCISCA",
        "authorized_official_middle_name": "ADA",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR/PRESIDENT",
        "authorized_official_telephone_number": "512-732-2122",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "TX",
            "license": "L1620",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP #",
            "identifier": "00773X",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "153758102",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TPI",
            "identifier": "173311501",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Summit Mental Health Clinic PA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Mar 10, 2008; 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.