REDICLINIC AUSTIN, LLC (NPI# 1558679662) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558679662 |
| Entity Type | Organization |
| Organization Name | REDICLINIC AUSTIN, LLC |
| Other Organization Name | REDICLINIC |
| Practice Address |
500 Canyon Ridge Dr Austin TX 78753-1632 |
| Mailing Address |
9 Greenway Plz Houston TX 77046-0905 |
| Practice Telephone | 5128369000 |
| Practice Fax Number | 5128369003 |
| Enumeration Date | 2010-09-23 |
| Last Update Date | 2014-06-05 |
| Authorized Official Name | MS. DANIELLE BARRERA (CHIEF OPERATING OFFICER) |
| Authorized Official Telephone | 7135809489 |
| Is Organization Subpart | Y |
| Parent Organization Name | REDICLINIC, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| RediClinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235594821 | Rediclinic Austin, LLC | Clinic/Center | 14028 N Highway 183, Bldg. A, Austin, TX 78717-5992 | 2015-12-23 |
| 1942603477 | Rediclinic Austin, LLC | Clinic/Center | 250 University Blvd., Round Rock, TX 78665 | 2014-09-29 |
| 1154723427 | Rediclinic Austin, LLC | Clinic/Center | 170 E. Whitestone, Cedar Park, TX 78613 | 2014-09-18 |
| 1407258775 | Rediclinic Austin, LLC | Clinic/Center | 598 E. Hwy Us 290, Dripping Springs, TX 78620 | 2014-09-18 |
| 1770780777 | Rediclinic Austin, LLC | Clinic/Center | 651 N. Us Hwy 183, Leander, TX 78641 | 2007-07-02 |
| 1063530632 | Rediclinic Austin, LLC | Clinic/Center | 11521 Ranch Road 620 N, Austin, TX 78726-1139 | 2007-03-26 |
| 1841508967 | Rediclinic Austin, LLC | Clinic/Center | 6900 Brodie Ln, Austin, TX 78745-5008 | 2010-09-23 |
| 1912104910 | Rediclinic Austin, LLC | Clinic/Center | 5401 South Fm 1626, Kyle, TX 78640 | 2007-07-02 |
| 1700954211 | Rediclinic Austin, LLC | Clinic/Center | 1700 E Palm Valley Blvd, Round Rock, TX 78664-4677 | 2006-12-01 |
| Street Address |
500 CANYON RIDGE DR |
| City | AUSTIN |
| State | TX |
| Zip Code | 78753-1632 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366418519 | Kirby Reed | Nurse Practitioner | 500 Canyon Ridge Dr, Suite J350, Austin, TX 78753-1632 | 2006-02-27 |
| 1134772122 | Richard Barnum Gustafson | Pharmacist | 500 Canyon Ridge Dr, Austin, TX 78753-1632 | 2019-07-19 |
| 1972059103 | Samir Alrajab | Dentist | 500 Canyon Ridge Dr, Austin, TX 78753-1632 | 2016-08-28 |
| 1396198552 | Melissa Jean Harper | Nurse Practitioner | 500 Canyon Ridge Dr, Austin, TX 78753-1632 | 2016-07-22 |
| 1164853461 | Carrie Banigan Hodges | Nurse Practitioner | 500 Canyon Ridge Dr, Austin, TX 78753-1632 | 2013-12-11 |
| 1497189195 | Gabrielle Mccart | Nurse Practitioner | 500 Canyon Ridge Dr, Austin, TX 78753-1632 | 2013-08-29 |
| 1861733735 | Mark Zamutt | Pharmacist | 500 Canyon Ridge Dr, Austin, TX 78753-1632 | 2013-03-01 |
| 1407196363 | Shannon Zucca | Pharmacist | 500 Canyon Ridge Dr, Austin, TX 78753-1632 | 2013-02-28 |
| 1437476256 | Todd Ellsworth | Pharmacist | 500 Canyon Ridge Dr, Austin, TX 78753-1632 | 2010-05-04 |
| 1720305634 | Anita Jenson | Pharmacist | 500 Canyon Ridge Dr, Austin, TX 78753-1632 | 2010-05-02 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306486659 | Gc Mental Wellness LLC | Counselor | 601 Farley Drive, Austin, TX 78753 | 2020-01-14 |
| 1871142992 | Virgie Lee Clement | Technician | 9704 Kendal Dr, 9704 Kendal Dr, Austin, TX 78753 | 2019-09-11 |
| 1851870190 | Mallory Lynch, Od, Pllc | Optometrist | 500 Canyon Ridge Dr. Suite L300, Austin, TX 78753 | 2018-08-08 |
| 1205320538 | Cameron Health Care LLC | Skilled Nursing Facility | 8324 Cameron Road, Austin, TX 78753 | 2018-06-20 |
| 1851883433 | Greater Austin Transportation Company | Taxi | 10630 Joseph Clayton Dr., Bldg A, Austin, TX 78753 | 2018-05-31 |
| 1093212151 | Enamel Dentistry Parmer Park, Pllc | Dentist | 1606 E. Parmer Ln, Suite #125, Austin, TX 78753 | 2018-04-06 |
| 1699270462 | Kelly Marcello | Nurse Practitioner | 11207 N Lamar Blvd Ste B, Austin, TX 78753 | 2018-03-26 |
| 1710481155 | Techridge Oaks, LLC | Assisted Living Facility | 400 E Yager Ln, Austin, TX 78753 | 2018-03-21 |
| 1013441286 | Mydental At Norwood Pllc | Dentist | 1045 Norwood Park Blvd, Suite 103, Austin, TX 78753 | 2017-04-14 |
| 1477908093 | Nicole Amy Kosich | Massage Therapist | 8740 N. Lamar Blvd., Austin, TX 78753 | 2016-05-02 |
| Find all providers in zip 78753 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114531167 | Action Potential - Sports and Neurological Rehab, Pllc | Clinic/Center | 3816 S Lamar Blvd Apt 2712, Austin, TX 78704-7955 | 2020-09-06 |
| 1588280515 | Pilsun LLC | Clinic/Center | 206 E 9th St Ste 1300, Austin, TX 78701-4411 | 2020-06-25 |
| 1447874334 | Dose Management Pa | Clinic/Center | 2111 Kramer Ln, Austin, TX 78758-4069 | 2020-06-05 |
| 1326686494 | Code 1 Concierge Care | Clinic/Center | 14101 Us 290 W, Suite 400b, Austin, TX 78737-2445 | 2019-12-19 |
| 1649748476 | Greenbrook Tms Austin Central LLC | Clinic/Center | 3705 Medical Pkwy Ste 450, Austin, TX 78705-1024 | 2018-11-09 |
| 1497283865 | Federal Comp and Wellness Pa | Clinic/Center | 5920 W William Cannon Dr Ste 140, Austin, TX 78749-1902 | 2017-05-31 |
| 1720525348 | Neurology Solutions Consultants, P.a. | Clinic/Center | 12345 N. Lamar Blvd, Suite 260, Austin, TX 78753-1306 | 2017-01-20 |
| 1700328606 | Everlywell | Clinic/Center | 800 W Cesar Chavez St, Austin, TX 78701-4008 | 2016-11-08 |
| 1679029862 | Two Hands Chiropractic, Inc. | Clinic/Center | 1602 E Riverside Dr, Austin, TX 78741-1006 | 2016-08-29 |
| 1235594821 | Rediclinic Austin, LLC | Clinic/Center | 14028 N Highway 183, Bldg. A, Austin, TX 78717-5992 | 2015-12-23 |
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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.