ROCKDALE BLACKHAWK LLC (NPI# 1073924932) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073924932 |
| Entity Type | Organization |
| Organization Name | ROCKDALE BLACKHAWK LLC |
| Other Organization Name | LITTLE RIVER HEALTHCARE SPECIALITY CLINIC |
| Practice Address |
1512 Leander Rd Georgetown TX 78628-8801 |
| Practice Telephone | 5129487611 |
| Enumeration Date | 2014-05-14 |
| Last Update Date | 2014-05-14 |
| Authorized Official Name | JEFFREY P MADISON (CEO) |
| Authorized Official Telephone | 5124464500 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 335E00000X | Prosthetic/Orthotic Supplier | Suppliers |
| Other Name | Type Code |
|---|---|
| Little River Healthcare Speciality Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407072358 | Rockdale Blackhawk LLC | Clinic/Center | 708 N Crockett Ave, Cameron, TX 76520-2551 | 2007-04-18 |
| 1679904577 | Rockdale Blackhawk LLC | Durable Medical Equipment & Medical Supplies | 1905 Sw H K Dodgen Loop, Temple, TX 76502-1814 | 2013-12-03 |
| 1174953467 | Rockdale Blackhawk LLC | Durable Medical Equipment & Medical Supplies | 1717 Sw H K Dodgen Loop, Temple, TX 76502-1838 | 2013-11-22 |
| 1811339831 | Rockdale Blackhawk LLC | Prosthetic/Orthotic Supplier | 1904 Railroad St, Georgetown, TX 78626-7718 | 2013-07-18 |
| 1033483086 | Rockdale Blackhawk LLC | General Practice | 5656 Bee Cave Rd, Suite M-300, West Lake Hills, TX 78746-5280 | 2012-03-07 |
| 1245514975 | Rockdale Blackhawk LLC | Clinic/Center | 715 Discovery Blvd, Suite 102, Cedar Park, TX 78613-2287 | 2011-09-29 |
| 1831479682 | Rockdale Blackhawk LLC | Clinic/Center | 1528 Leander Rd, Georgetown, TX 78628-8801 | 2011-08-25 |
| 1295015055 | Rockdale Blackhawk LLC | Clinic/Center | 3101 Highway 71 E, Suite 101, Bastrop, TX 78602-5156 | 2011-08-25 |
| 1083903843 | Rockdale Blackhawk LLC | Physiological Laboratory | 3692 E Sam Houston Pkwy S, Pasadena, TX 77505-3137 | 2011-04-01 |
| 1427353770 | Rockdale Blackhawk LLC | Clinic/Center | 3101 Highway 71 E, Suite 108, Bastrop, TX 78602-5156 | 2011-01-18 |
| Street Address |
1512 LEANDER RD |
| City | GEORGETOWN |
| State | TX |
| Zip Code | 78628-8801 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740789833 | Integrated Pain Associates Pa | Anesthesiology | 1512 Leander Rd, Georgetown, TX 78628-8801 | 2018-02-05 |
| 1124422662 | Little River Medical Group | Durable Medical Equipment & Medical Supplies | 1512 Leander Rd, Georgetown, TX 78628-8801 | 2014-10-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164079760 | Maegan Marissa Milliet | Student in an Organized Health Care Education/Training Program | 302 Rideg Run Dr, Georgetown, TX 78628 | 2019-08-20 |
| 1366918419 | Harold F. Adelman, M.d, Pllc | Clinic/Center | 3008 Dawn Drive, Suite #103, Georgetown, TX 78628 | 2018-10-16 |
| 1679085401 | Georgetown Emergency Physicians Pllc | Clinic/Center | 1210 W University Blvd, Georgetown, TX 78628 | 2017-11-02 |
| 1134631450 | Meredith Rollins Hatcher | Physician Assistant | 204 S Interstate I-35, Suite 103, Georgetown, TX 78628 | 2017-10-26 |
| 1588188304 | Wolf Ranch Dental Group, PC | Dentist | 1135 West University Avenue, Georgetown, TX 78628 | 2017-08-02 |
| 1982066528 | Imren Ozturk | Family Medicine | Arc Georgetown, 940 W University Ave Suite 101, Georgetown, TX 78628 | 2016-03-23 |
| 1093114100 | Della Davis | Hearing Instrument Specialist | 1013 W. University Ave, Suite 122, Georgetown, TX 78628 | 2014-08-14 |
| 1083988125 | Deann Reinshuttle | Audiologist-Hearing Aid Fitter | 3316 Williams Dr Ste 115, Georgetown, TX 78628 | 2012-03-07 |
| 1700195823 | Zeyad B Mughrabi | Dentist | 1615 Williams Dr, Georgetown, TX 78628 | 2010-10-07 |
| 1497071534 | Jeri Lynne Manhal | Counselor | 1618 Williams Dr., Suite 4, Georgetown, TX 78628 | 2010-04-14 |
| Find all providers in zip 78628 | ||||
| Taxonomy Code | 335E00000X |
| Grouping | Suppliers |
| Classification | Prosthetic/Orthotic Supplier |
| An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition. |
| Notes: Source: American Board for Certification in Orthotics, Prosthetics, and Pedorthics, Inc. [7/1/2010: modified, 7/1/2013: modified] Additional Resources: American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc., www.abcop.org and Board of Certification/Accreditation, International, www.bocusa.org. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114436359 | Select Physical Therapy Texas Limited Partnership | Prosthetic/Orthotic Supplier | 4112 Williams Dr Ste 103, Georgetown, TX 78628-1336 | 2017-09-20 |
| 1700846144 | Floyd Brace Company, Inc. | Prosthetic/Orthotic Supplier | 407 Church Street, Unit D, Georgetown, SC 29440 | 2006-03-27 |
| 1811339831 | Rockdale Blackhawk LLC | Prosthetic/Orthotic Supplier | 1904 Railroad St, Georgetown, TX 78626-7718 | 2013-07-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124627997 | Tactical Rehabilitation Inc | Prosthetic/Orthotic Supplier | 2710 S. Clear Creek, Suite 110, Killeen, TX 76549-6685 | 2020-10-22 |
| 1962001123 | Tactical Rehabilitation Inc | Prosthetic/Orthotic Supplier | 2710 Clear Creek Rd Apt 110, Killeen, TX 76549-6685 | 2020-10-20 |
| 1871191643 | Cranial Technologies, Inc. | Prosthetic/Orthotic Supplier | 2020 W State Highway 114 Ste 360, Grapevine, TX 76051-8649 | 2020-10-14 |
| 1396351573 | Baker O & P Enterprises, Inc. | Prosthetic/Orthotic Supplier | 1104 West 34th St., Bldg. A, Austin, TX 78705-1910 | 2020-09-22 |
| 1184230815 | Lindas Signature Hair Studio Inc | Prosthetic/Orthotic Supplier | 9415 Broadway St Ste 201, Pearland, TX 77584-8094 | 2020-09-18 |
| 1538773106 | Memorial Prosthetics and Orthotics Inc | Prosthetic/Orthotic Supplier | 439 Mason Park Blvd Ste A1, Katy, TX 77450-4163 | 2020-09-01 |
| 1447861828 | Major Miracles Rx | Prosthetic/Orthotic Supplier | 1801 E 51st St Ste 362, Austin, TX 78723-3434 | 2020-08-11 |
| 1396355061 | Ameristep Prosthetics San Antonio | Prosthetic/Orthotic Supplier | 7271 Wurzbach Rd Ste 187, San Antonio, TX 78240-3800 | 2020-08-06 |
| 1043820327 | Ameristep Prosthetics Southwestern | Prosthetic/Orthotic Supplier | 5406 Harry Hines Blvd, Dallas, TX 75235-7211 | 2020-08-03 |
| 1083230502 | Amazing Wig Closet | Prosthetic/Orthotic Supplier | 409 W Front St Ste 100-306, Hutto, TX 78634-4204 | 2020-06-20 |
| Find all providers with the same taxonomy | ||||
| City | GEORGETOWN |
| Zip Code | 78628 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.