Individual provider Active NPI

James R Merryman, DO

  • Family Medicine Physician
  • Austin, TX
National Provider Identifier
1710993076
Registry record updated Dec 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
H0629 Issued in TX
Practice address
4515 Seton Center Pkwy #220
Austin, TX 78759-5784
Phone
(512) 338-8388
Fax
(512) 338-8427
NPI assigned
Jul 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X H0629 TX Primary

Addresses

Primary practice location

4515 Seton Center Pkwy #220
Austin, TX 78759-5784

Mailing address

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

Other identifiers 4

IdentifierTypeStateIssuer
122914806MedicaidTX
080155984MedicaidTX
122914805MedicaidTX
122914803MedicaidTX

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
I20081020000620 TX Practitioner - Family Practice 8527126523 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Austin Regional Clinic PAGroup PAC ID 3072507789, 398 clinicians

Practice addresses (Care Compare)

4515 Seton Ctr Pkwy
220 Arc Quarry Lake
Austin, TX 78759-5784
Phone (512) 338-8388

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
H0629TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Austin Regional Clinic, PA Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jmerryman3648@arcmd.direct-ci.com

Organizations & group practices 2

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": "1323216000000",
    "number": "1710993076",
    "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": "4515 SETON CENTER PKWY #220",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787595784",
            "telephone_number": "512-338-8388",
            "fax_number": "512-338-8427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERRYMAN",
        "first_name": "JAMES",
        "middle_name": "R",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2011-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "H0629",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "122914806",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "080155984",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "122914805",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "122914803",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.