Active NPI
Austin Fagerbrg
- Emergency Medicine Physician
- Austin, TX
National Provider Identifier
1942057765
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 783630
- Practice address
- 1500 Red River St
Austin, TX 78701-1918 - Phone
- (512) 324-7000
- NPI assigned
- Apr 30, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 783630 | TX | Primary |
Addresses
Primary practice location
1500 Red River St
Austin, TX 78701-1918
Mailing address
7120 Kings Row
Austin, TX 78746-5063
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 783630 | TX | MD | Emergency Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1714435200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1714435200000",
"number": "1942057765",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7120 KINGS ROW",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787465063"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1500 RED RIVER ST",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787011918",
"telephone_number": "512-324-7000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAGERBRG",
"first_name": "AUSTIN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-04-30",
"last_updated": "2024-04-30",
"certification_date": "2024-04-30",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "TX",
"license": "783630",
"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 Apr 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.