Individual provider Active NPI

Clifford Jack Fraim, M.D.

  • Neurology Physician
  • Austin, TX
National Provider Identifier
1942314406
Registry record updated Dec 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
E4337 Issued in TX
Practice address
1600 W 38TH St Ste 308
Austin, TX 78731-6406
Phone
(512) 324-3580
Fax
(512) 324-3581
NPI assigned
Aug 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X E4337 TX Primary

Addresses

Primary practice location

1600 W 38TH St Ste 308
Austin, TX 78731-6406

Mailing address

1400 N Ih 35 Ste 300
Austin, TX 78701-1926
Phone (512) 324-8300

Other identifiers 4

IdentifierTypeStateIssuer
131702609MedicaidTX
8CX265OtherTXBCBS
131702610MedicaidTX
1317026-08MedicaidTX

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
E4337TXMDNeurology Physician

NPI Registry JSON

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355443200000",
    "number": "1942314406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 N IH 35 STE 300",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787011926",
            "telephone_number": "512-324-8300",
            "fax_number": "512-324-8301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 W 38TH ST STE 308",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787316406",
            "telephone_number": "512-324-3580",
            "fax_number": "512-324-3581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRAIM",
        "first_name": "CLIFFORD",
        "middle_name": "JACK",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-19",
        "last_updated": "2012-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "TX",
            "license": "E4337",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "131702609",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8CX265",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "131702610",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1317026-08",
            "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 14, 2012; 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.