Active NPI
Neurology and Electromyography Clinic
- Neurology Physician
- Austin, TX
National Provider Identifier
1912183641
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- L2112
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physician | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 155764701 | Medicaid | TX | |
| 00579T | Other | TX | BCBS |
National Provider Directory
National Provider DirectoryLocations
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.
-
- Neurology Physician
- Madison, WI
- NPI 1750493243
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.