NPIMap

Organization Active NPI

Luna Medicine

  • General Practice Physician
  • Austin, TX
National Provider Identifier
1952683526
Registry record updated Sep 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
F9520 Issued in TX
Legal business name
LUNA MEDICINE
Doing business as
Austin Wellness Clinic
Practice address
1700 S Lamar Blvd
Suite 240
Austin, TX 78704-8962
Phone
(512) 473-8900
Fax
(512) 472-9898
NPI assigned
Sep 9, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2011

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

Authorized official

Name
Dr. John M. Haest, M.D.
Title
President
Phone
(512) 473-8900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X F9520 TX Primary

Addresses

Primary practice location

1700 S Lamar Blvd
Suite 240
Austin, TX 78704-8962

Mailing address

1700 S Lamar Blvd
Suite 240
Austin, TX 78704-8962
Phone (512) 473-8900

Other names 1

  • Austin Wellness Clinic Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1315526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315526400000",
    "number": "1952683526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 S LAMAR BLVD",
            "address_2": "SUITE 240",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787048962",
            "telephone_number": "512-473-8900",
            "fax_number": "512-472-9898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 S LAMAR BLVD",
            "address_2": "SUITE 240",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787048962",
            "telephone_number": "512-473-8900",
            "fax_number": "512-472-9898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUNA MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-09",
        "last_updated": "2011-09-09",
        "status": "A",
        "authorized_official_last_name": "HAEST",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "512-473-8900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "TX",
            "license": "F9520",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Austin Wellness Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Sep 9, 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.