NPIMap

Organization Active NPI

Rockdale Blackhawk, LLC

  • Orthopaedic Surgery Physician
  • Bastrop, TX
National Provider Identifier
1760926604
Registry record updated Dec 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
ROCKDALE BLACKHAWK, LLC
Practice address
623 Hwy 71 W
Suite 204
Bastrop, TX 78602-4166
Phone
(512) 451-1969
NPI assigned
Dec 12, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2016

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

Authorized official

Name
Jeff Madison
Title
Ceo
Phone
(512) 481-7060

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207X00000X Primary

Addresses

Primary practice location

623 Hwy 71 W
Suite 204
Bastrop, TX 78602-4166

Mailing address

623 Hwy 71 W
Suite 204
Bastrop, TX 78602-4166
Phone (512) 451-1969

Other names 1

  • Little River Healthcare Southwest Orthopedic Group Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Rockdale Blackhawk LLC15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

Organizations that report the same tax identification number in the National Provider Directory.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1481500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481500800000",
    "number": "1760926604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "623 HWY 71 W",
            "address_2": "SUITE 204",
            "city": "BASTROP",
            "state": "TX",
            "postal_code": "786024166",
            "telephone_number": "512-451-1969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "623 HWY 71 W",
            "address_2": "SUITE 204",
            "city": "BASTROP",
            "state": "TX",
            "postal_code": "786024166",
            "telephone_number": "512-451-1969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROCKDALE BLACKHAWK, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-12",
        "last_updated": "2016-12-12",
        "status": "A",
        "authorized_official_last_name": "MADISON",
        "authorized_official_first_name": "JEFF",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "512-481-7060"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Little River Healthcare Southwest Orthopedic Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bastrop, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2016; 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.