NPIMap

Organization Active NPI

Austin Diagnostic Clinic

  • Hospitalist Physician
  • Austin, TX
National Provider Identifier
1972011658
Registry record updated Jan 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
Legal business name
AUSTIN DIAGNOSTIC CLINIC
Practice address
12221 N Mopac Expy
Austin, TX 78758-2401
Phone
(512) 901-4009
Fax
(512) 901-3909
NPI assigned
Jan 17, 2018
Last updated
Jan 25, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2018

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

Authorized official

Name
Christina Shannon
Title
Credentialing Specialist
Phone
(512) 901-4937

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X Primary

Addresses

Primary practice location

12221 N Mopac Expy
Austin, TX 78758-2401

Mailing address

12221 N Mopac Expy
Austin, TX 78758-2401
Phone (512) 901-4937

Other identifiers 1

IdentifierTypeStateIssuer
1073591202MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031112000236 TX Part B Supplier - Clinic/Group Practice 1254244551 Receives reassigned benefits from 132 practitioners
24 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

Other NPIs on the same Medicare enrollment 24

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 24

National Provider Directory

National Provider Directory
Tax ID family
The Austin Diagnostic Clinic Association20 organizations share this tax ID, including this one

Other organizations with this tax ID 19

Organizations that report the same tax identification number in the National Provider Directory.

View all 19

Locations

1111 W 34th St
Austin, TX 78705
Phone (512) 343-2466

12221 N Mopac Expy
Austin, TX 78758
Phone (512) 901-2530

3508 Far West Blvd
Austin, TX 78731
Phone (512) 828-3990

4315 James Casey St
Austin, TX 78745
Phone (512) 460-3404

621 Radam Ln
Austin, TX 78745
Phone (512) 707-7601

7307 Creekbluff Dr
Austin, TX 78750
Phone (512) 346-6969

801 W 34th St
Austin, TX 78705
Phone (512) 459-1111

1201 N Lakeline Blvd
Ste 100
Cedar Park, TX 78613
Phone (512) 259-1329

1320 Arrow Point Dr
Cedar Park, TX 78613
Phone (512) 260-6990

3201 S Austin Ave
Ste 205
Georgetown, TX 78626
Phone (512) 763-4060

505 Saint Davids Loop
Ste 311A
Leander, TX 78641
Phone (512) 819-0132

1711 S Colorado St
Ste C
Lockhart, TX 78644
Phone (512) 805-0680

1515 N US Highway 281
Marble Falls, TX 78654
Phone (830) 798-9575

1499 E Old Settlers Blvd
Ste A
Round Rock, TX 78664

Practitioners & affiliated clinicians

Practitioners 135

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 135

NPI Registry JSON

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

{
    "created_epoch": "1516147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1516838400000",
    "number": "1972011658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12221 N MOPAC EXPY",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787582401",
            "telephone_number": "512-901-4937",
            "fax_number": "512-901-3945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12221 N MOPAC EXPY",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787582401",
            "telephone_number": "512-901-4009",
            "fax_number": "512-901-3909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUSTIN DIAGNOSTIC CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-17",
        "last_updated": "2018-01-25",
        "status": "A",
        "authorized_official_last_name": "SHANNON",
        "authorized_official_first_name": "CHRISTINA",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "512-901-4937"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1073591202",
            "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 Jan 25, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.