Organization Active NPI

Neurology and Electromyography Clinic

  • Neurology Physician
  • Austin, TX
National Provider Identifier
1912183641
Registry record updated Dec 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
L2112 Issued in TX
Legal business name
NEUROLOGY AND ELECTROMYOGRAPHY CLINIC
Practice address
4201 Marathon Blvd
Ste 304
Austin, TX 78756-3436
Phone
(512) 371-1200
NPI assigned
Jan 11, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2011

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

Authorized official

Name
Gary Campbell
Title
Account Manager
Phone
(512) 674-9002

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084N0400X L2112 TX Primary

Addresses

Primary practice location

4201 Marathon Blvd
Ste 304
Austin, TX 78756-3436

Mailing address

4201 Marathon Blvd
Ste 304
Austin, TX 78756-3410
Phone (512) 371-1200

Other identifiers 2

IdentifierTypeStateIssuer
155764701MedicaidTX
00579TOtherTXBCBS

National Provider Directory

National Provider Directory

Locations

4201 Marathon Blvd
Ste 304
Austin, TX 78756
Phone (512) 293-6822

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": "1200009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1324252800000",
    "number": "1912183641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 MARATHON BLVD",
            "address_2": "STE 304",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787563410",
            "telephone_number": "512-371-1200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 MARATHON BLVD",
            "address_2": "STE 304",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787563436",
            "telephone_number": "512-371-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROLOGY AND ELECTROMYOGRAPHY CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-11",
        "last_updated": "2011-12-19",
        "status": "A",
        "authorized_official_last_name": "CAMPBELL",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "ACCOUNT MANAGER",
        "authorized_official_telephone_number": "512-674-9002"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "TX",
            "license": "L2112",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "155764701",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "00579T",
            "state": "TX"
        }
    ],
    "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 Dec 19, 2011; 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.