LEGACY HEART CARE OF AUSTIN LLC (NPI# 1336304732) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336304732 |
| Entity Type | Organization |
| Organization Name | LEGACY HEART CARE OF AUSTIN LLC |
| Practice Address |
901 W 38th St Suite 403 Austin TX 78705-1163 |
| Mailing Address |
2500 West Fwy Suite 200 Fort Worth TX 76102-5848 |
| Practice Telephone | 8174234400 |
| Practice Fax Number | 8174238080 |
| Mailing Telephone | 8174234400 |
| Mailing Fax Number | 8174238080 |
| Enumeration Date | 2008-07-24 |
| Last Update Date | 2012-06-21 |
| Authorized Official Name | MICHAEL GRATCH (PRESIDENT) |
| Authorized Official Telephone | 8174234400 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 364S00000X | Clinical Nurse Specialist | 654915 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
901 W 38TH ST SUITE 403 |
| City | AUSTIN |
| State | TX |
| Zip Code | 78705-1163 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609861897 | Russell A Hayhurst | Ophthalmology | 901 W 38th St, Ste 303, Austin, TX 78705-1163 | 2005-09-14 |
| 1124598917 | Seton Oral & Maxillofacial Surgery | Dentist | 901 W 38th St, Suite 410, Austin, TX 78705 | 2018-12-05 |
| 1437532850 | Wilshire Interventional Pain Center LLC | Nurse Anesthetist, Certified Registered | 901 W 38th St, Suite 101, Austin, TX 78705-1163 | 2015-07-02 |
| 1336522754 | Sc Spine Partners LLC | Nurse Anesthetist, Certified Registered | 901 W 38th St, Suite 101, Austin, TX 78705-1163 | 2015-07-02 |
| 1609265891 | Abs Spine Partners LLC | Clinic/Center | 901 W 38th St, Suite 101, Austin, TX 78705-1163 | 2015-01-12 |
| 1972925105 | Michelle Kim | Dentist | 901 W 38th St, Suite 410, Austin, TX 78705-1163 | 2014-01-07 |
| 1457617821 | Westlake Interventional Pain Center LLC | Clinic/Center | 901 W 38th St, Suite 101, Austin, TX 78705-1163 | 2012-04-10 |
| 1992071922 | Cristina Salazar | Physician Assistant | 901 W 38th St, Suite 301, Austin, TX 78705-1163 | 2012-03-23 |
| 1174897870 | Rachel Alicia Smith | Physician Assistant | 901 W 38th St, Suite 200, Austin, TX 78705-1163 | 2012-02-28 |
| 1720370760 | Lauren Nicole Sederholm | Physician Assistant | 901 W 38th St, Suite 200, Austin, TX 78705-1163 | 2011-05-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740894559 | Ben Aviel | Specialist/Technologist | 2501 Leon, Austin, TX 78705 | 2020-08-31 |
| 1700408739 | Julie Marie Dorland | Obstetrics & Gynecology | Ut Austin Dell Medical School Obgyn Medical Park Tower, 1301 W 38th St, Suite 705, Austin, TX 78705 | 2020-05-13 |
| 1952941155 | Oluwakemi Yemi-ese | Counselor | 2717 Rio Grande Street, Austin, TX 78705 | 2020-01-15 |
| 1285272765 | Lisa K Wheeler | Counselor | 2520 Longivew Street, Suite 313, Austin, TX 78705 | 2019-12-16 |
| 1033767637 | Olivia May Neel | Specialist/Technologist | 620 West 24th Street, 208a, Austin, TX 78705 | 2019-08-28 |
| 1336795202 | Grace Evelyn Martin | Specialist/Technologist | University of Texas, 110 Inner Campus Drive, Austin, TX 78705 | 2019-08-15 |
| 1801450317 | Nicole Buchele | Obstetrics & Gynecology | Ut Austin Dell Medical School-obgyn, Medical Park Tower, 1301 W 38th St, Suite 705, Austin, TX 78705 | 2019-04-30 |
| 1124502794 | Joan Margaret Carroll | Physician Assistant | 3000 N, I-35, Suite 600, Austin, TX 78705 | 2018-09-19 |
| 1841797636 | Corbin Anne Weaver | Obstetrics & Gynecology | Medical Park Tower, 1301 W. 38th St., Suite 705, Austin, TX 78705 | 2018-04-09 |
| 1740707892 | Christine Marie Falk | Specialist/Technologist | 2810 Hemphill Park, Apt 211, Austin, TX 78705 | 2017-08-29 |
| Find all providers in zip 78705 | ||||
| Taxonomy Code | 364S00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Clinical Nurse Specialist |
| A registered nurse who, through a graduate degree program in nursing, or through a formal post-basic education program or continuing education courses and clinical experience, is expert in a specialty area of nursing practice within one or more of the components of direct patient/client care, consultation, education, research and administration. |
| Notes: Sources: American Nurses Association, American Nurses Credentialing Center, 1996 Certification Catalogue and The Interagency Conference on Nursing Statistics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962016519 | Jennie Rose Posey | Clinical Nurse Specialist | 6500 N. Mopac Expressway, Building 3, Suite 200, Austin, TX 78731 | 2020-09-01 |
| 1831680040 | Carmen Floy Lagrone | Clinical Nurse Specialist | 6901 Mckinney Falls Pkwy, Austin, TX 78744-8401 | 2018-05-23 |
| 1932637378 | Virginia Ducote Remeny | Clinical Nurse Specialist | 4316 Companeros Way, Austin, TX 78749-3650 | 2017-05-30 |
| 1215281738 | Elizabeth Ann White | Clinical Nurse Specialist | 818 East 53rd Street, Austin, TX 78751 | 2012-11-06 |
| 1003429986 | Ryan Webb | Clinical Nurse Specialist | 12731 Research Blvd Ste B200, Austin, TX 78759-4387 | 2020-08-28 |
| 1083267702 | Gregory Adrian Greenberg | Clinical Nurse Specialist | 1301 W 38th St Ste 403, Austin, TX 78705-1013 | 2019-07-22 |
| 1093372955 | Gremar Corpuz | Clinical Nurse Specialist | 1500 Red River St, Austin, TX 78701-1918 | 2019-05-24 |
| 1699277756 | Evelina Joanna Kaminski | Clinical Nurse Specialist | 1020 W 34th St, Austin, TX 78705-2009 | 2018-03-05 |
| 1588164263 | Adrienne Alexandra Brenner | Clinical Nurse Specialist | 1500 Red River St, Austin, TX 78701-1918 | 2018-02-19 |
| 1225553688 | Joseph Christopher Lord | Clinical Nurse Specialist | 3215 Steck Ave Ste 200, Austin, TX 78757-8060 | 2017-08-07 |
| Find all providers in AUSTIN | ||||
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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.