NPIMap

Organization Active NPI

Austin Children'S Shelter

  • Pediatric Nurse Practitioner
  • Austin, TX
National Provider Identifier
1801078241
Registry record updated Nov 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
596183 Issued in TX
Legal business name
AUSTIN CHILDREN'S SHELTER
Practice address
1501 Enfield Rd
Austin, TX 78703
Phone
(512) 499-0090
Fax
(512) 499-0438
NPI assigned
Nov 28, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2007

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

Authorized official

Name
Mr. Jerry Fye
Title
Deputy Director of Finance
Phone
(512) 499-0090

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363LP0200X 596183 TX Primary

Addresses

Primary practice location

1501 Enfield Rd
Austin, TX 78703

Mailing address

804 Rio Grande St Ste C
Austin, TX 78701-2201
Phone (512) 499-0090

National Provider Directory

National Provider Directory
Tax ID family
Austin Children'S Shelter3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

804 Rio Grande St
Ste C
Austin, TX 78701

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1196208000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196208000000",
    "number": "1801078241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 RIO GRANDE ST STE C",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787012201",
            "telephone_number": "512-499-0090",
            "fax_number": "512-499-0438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 ENFIELD RD",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "78703",
            "telephone_number": "512-499-0090",
            "fax_number": "512-499-0438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUSTIN CHILDREN'S SHELTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-28",
        "last_updated": "2007-11-28",
        "status": "A",
        "authorized_official_last_name": "FYE",
        "authorized_official_first_name": "JERRY",
        "authorized_official_title_or_position": "DEPUTY DIRECTOR OF FINANCE",
        "authorized_official_telephone_number": "512-499-0090",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "596183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Nov 28, 2007; 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.