NPIMap

Organization Active NPI

Lone Star Circle of Care

Doing business as A.W. Grimes Medical Offices

  • Federally Qualified Health Center (FQHC)
  • Round Rock, TX
National Provider Identifier
1790937738
Registry record updated Mar 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
LONE STAR CIRCLE OF CARE
Doing business as
A.W. Grimes Medical Offices
Practice address
2051 Gattis School Rd
Suite 250
Round Rock, TX 78664-7441
Phone
(877) 800-5722
Fax
(512) 238-5492
NPI assigned
Oct 22, 2008
Last updated
Mar 3, 2011By the provider in NPPES
Organization subpart
Yes
Parent organization
LONE STAR CIRCLE OF CAREAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 3, 2011

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

Authorized official

Name
Mr. Peter C Perialas Jr.
Title
Chief Executive Officer
Phone
(512) 868-1124

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X TX Primary

Addresses

Primary practice location

2051 Gattis School Rd
Suite 250
Round Rock, TX 78664-7441

Mailing address

205 E University Ave
Suite 200
Georgetown, TX 78626-6814
Phone (512) 868-1124

Other identifiers 1

IdentifierTypeStateIssuer
206351301MedicaidTX

Other names 1

  • A.W. Grimes Medical Offices Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040622000184 TX Part B Supplier - Clinic/Group Practice 5193709392 Receives reassigned benefits from 181 practitioners
39 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Austin, TX; Taylor, TX; Round Rock, TX; Pflugerville, TX; Killeen, TX; Jonestown, TX; Hutto, TX; Harker Heights, TX…

Other NPIs on the same Medicare enrollment 39

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 39

National Provider Directory

National Provider Directory
Part of
Georgetown Community Clinic

NPI Registry JSON

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

{
    "created_epoch": "1224633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1299110400000",
    "number": "1790937738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 E UNIVERSITY AVE",
            "address_2": "SUITE 200",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786266814",
            "telephone_number": "512-868-1124",
            "fax_number": "512-868-9894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2051 GATTIS SCHOOL RD",
            "address_2": "SUITE 250",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786647441",
            "telephone_number": "877-800-5722",
            "fax_number": "512-238-5492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONE STAR CIRCLE OF CARE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LONE STAR CIRCLE OF CARE",
        "enumeration_date": "2008-10-22",
        "last_updated": "2011-03-03",
        "status": "A",
        "authorized_official_last_name": "PERIALAS",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "512-868-1124",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "206351301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "A.W. Grimes Medical Offices",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Round Rock, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2011; 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.