ROCKDALE BLACKHAWK, LLC (NPI# 1538610274) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538610274 |
| Entity Type | Organization |
| Organization Name | ROCKDALE BLACKHAWK, LLC |
| Other Organization Name | LITTLE RIVER HEALTHCARE TRANSITIONS GERIATRICS GROUP |
| Practice Address |
2200 Park Bend Dr Bldg 2-301 Austin TX 78758-5387 |
| Mailing Address |
1 Chisholm Trl Suite 400 Round Rock TX 78681-5008 |
| Practice Telephone | 5123513919 |
| Mailing Telephone | 5124817060 |
| Enumeration Date | 2016-10-18 |
| Last Update Date | 2016-10-18 |
| 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 | 208D00000X | General Practice | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Little River Healthcare Transitions Geriatrics Group | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811489974 | Rockdale Blackhawk, LLC | Clinic/Center | 1909 Sw Hk Dodgen Loop, Temple, TX 76502 | 2018-06-05 |
| 1760926604 | Rockdale Blackhawk, LLC | Orthopaedic Surgery | 623 Hwy 71 W, Suite 204, Bastrop, TX 78602-4166 | 2016-12-12 |
| 1124562053 | Rockdale Blackhawk, LLC | Orthopaedic Surgery | 815 Hwy 71 W, Suite 1150, Bastrop, TX 78602-0319 | 2016-12-12 |
| 1437693363 | Rockdale Blackhawk, LLC | Orthopaedic Surgery | 2500 West William Cannon Drive, Suite 401, Austin, TX 78745-5290 | 2016-12-12 |
| 1407399884 | Rockdale Blackhawk, LLC | Orthopaedic Surgery | 207 W Avenue E, Suite 1000, Lampasas, TX 76550-1820 | 2016-12-02 |
| 1285911123 | Rockdale Blackhawk, LLC | Clinic/Center | 1700 Brazos, Suite A, B and C, Rockdale, TX 76567 | 2011-11-07 |
| 1972047801 | Rockdale Blackhawk, LLC | Orthopaedic Surgery | 135 Bunton Creek Road, Suite 302a, Kyle, TX 78640-5701 | 2016-12-12 |
| 1437448156 | Rockdale Blackhawk, LLC | Physiological Laboratory | 2401 Fm 646 Rd W, Suite B, Dickinson, TX 77539-3249 | 2011-04-04 |
| 1982894408 | Rockdale Blackhawk, LLC | Clinic/Center | 104 S Magnolia St, Hearne, TX 77859-2565 | 2007-07-31 |
| 1811100076 | Rockdale Blackhawk, LLC | General Acute Care Hospital | 1700 Brazos Ave, Rockdale, TX 76567-2517 | 2007-05-07 |
| Street Address |
2200 PARK BEND DR BLDG 2-301 |
| City | AUSTIN |
| State | TX |
| Zip Code | 78758-5387 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134115595 | Richard B Stovall | Neurological Surgery | 2200 Park Bend Dr, Bldg 2, Ste 201, Austin, TX 78758-5388 | 2005-09-21 |
| 1811410392 | Brenda Cobian Olmos | Nurse Practitioner | 2200 Park Bend Dr, Austin, TX 78758-5387 | 2017-07-17 |
| 1538612981 | Lily Swann | Physical Therapist | 2200 Park Bend Dr, Austin, TX 78758-5387 | 2016-08-02 |
| 1669826376 | Antionne Harp | Chiropractor | 2200 Park Bend Dr, Suite 300, Austin, TX 78758-5387 | 2016-04-19 |
| 1699154716 | Cs Surgical Pllc | Physician Assistant | 2200 Park Bend Dr, Ste 2-201, Austin, TX 78758-5387 | 2015-05-21 |
| 1699169276 | Tessa Gibbs | Nurse Practitioner | 2200 Park Bend Dr, Building 1 Suite 201, Austin, TX 78758-5388 | 2015-03-23 |
| 1063815769 | Neva M. Schmelzer | Nurse Practitioner | 2200 Park Bend Dr, Bldg 1, Suite 401, Austin, TX 78758-5387 | 2014-10-08 |
| 1851790083 | Matthew Gieringer | Physical Therapist | 2200 Park Bend Dr, Building 1 Suite 202, Austin, TX 78758-5387 | 2014-08-13 |
| 1629484852 | Sara Jean Linedecker | Pharmacist | 2200 Park Bend Dr, Bldg 1, Ste 300, Austin, TX 78758-5387 | 2014-07-08 |
| 1689097248 | Linh V. Ong | Nurse Anesthetist, Certified Registered | 2200 Park Bend Dr, Bldg 1, Suite 201, Austin, TX 78758-5387 | 2014-01-31 |
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|---|---|---|---|---|
| 1225644065 | Seton Family of Doctors | Internal Medicine | 3001 Palm Way, D1 : 134-138, Austin, TX 78758 | 2020-09-17 |
| 1083243661 | Donna Bella Laurel Portillo | Pharmacist | 12221 N Mopac Expwy, Austin, TX 78758 | 2020-04-05 |
| 1881249092 | Elizabeth Logan Anderson | Behavioral Analyst | 2100 Kramer Ln., Suite 150, Austin, TX 78758 | 2019-08-05 |
| 1295388502 | Bridget Sue Morgan | Behavioral Analyst | 2100 Kramer Ln #150, Austin, TX 78758 | 2019-07-17 |
| 1508326885 | Jonathan James Runnels | Anesthesiologist Assistant | 12221n Mopac, Austin, TX 78758 | 2019-03-22 |
| 1427527324 | Nayely Gutierrez | Dietitian, Registered | 8606 Delaware Ct, Austin, TX 78758 | 2018-11-20 |
| 1720569635 | Shari Wright | Licensed Vocational Nurse | 12349 Metric Blvs # 425, Austin, TX 78758 | 2018-08-28 |
| 1528545456 | Alexis N Bongiorno | Registered Nurse | 11901 Hobby Horse Court, 1516, Austin, TX 78758 | 2018-07-24 |
| 1679072573 | Lori Scott | Counselor | 1600 Payton Gin Road, Austin, TX 78758 | 2018-02-06 |
| 1003322488 | Lisa Robyn Lee | Behavior Technician | 2018 W Rundberg Ln, #13d, Austin, TX 78758 | 2017-12-20 |
| Find all providers in zip 78758 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
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|---|---|---|---|---|
| 1457974065 | Dagoberto Balderas, Do, Pllc | General Practice | 5424 W Highway 290 Ste 101, Austin, TX 78735-8838 | 2020-05-19 |
| 1225685712 | Integrative Medical Group of Texas | General Practice | 6905 West Gate Blvd. Ste A, Austin, TX 78745 | 2019-08-20 |
| 1356858377 | Where R U Now, LLC | General Practice | 7110 Cameron Rd Ste E, Austin, TX 78752-2868 | 2017-12-29 |
| 1073066239 | The University of Texas At Austin | General Practice | 1601 Trinity Street, Austin, TX 78712 | 2016-07-25 |
| 1306291620 | Healthy Schools Texas Pllc | General Practice | 9415 Burnet Rd, Ste 309b, Austin, TX 78758-5255 | 2016-04-25 |
| 1649694035 | John Maxwell | General Practice | 12817 Hacienda Rdg, Austin, TX 78738-7652 | 2014-02-06 |
| 1982031852 | Total Md Physicians Group, Pllc | General Practice | 12717 Shops Pkwy, Suite 500, Austin, TX 78738-6621 | 2013-10-08 |
| 1932440245 | Travis County Employee Wellness & Health | General Practice | 1010 Lavaca St # 221, Austin, TX 78701-2331 | 2013-03-12 |
| 1447590765 | David L King | General Practice | 10609 Pickfair Dr, Austin, TX 78750-4010 | 2013-02-23 |
| 1407101744 | Susan Elizabeth Zane | General Practice | 100 Pascal Ln, Austin, TX 78746-2506 | 2012-07-23 |
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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.