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ASERACARE HOSPICE
Complete NPI Record 1710029624
Hospice Care, Community Based in Round Rock, TX

NPI Status: Active since February 14, 2007

Contact Information

1212 E PALM VALLEY BLVD
ROUND ROCK, TX
ZIP 78664
Phone: (512) 218-9890

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Table of Contents

  1. NPI
  2. Entity Type Code
  3. Employer Identification Number EIN
  4. Provider Organization Name Legal Business Name
  5. Provider First Line Business Mailing Address
  6. Provider Business Mailing Address City Name
  7. Provider Business Mailing Address State Name
  8. Provider Business Mailing Address Postal Code
  9. Provider Business Mailing Address Country Code If outside U S
  10. Provider Business Mailing Address Telephone Number
  11. Provider First Line Business Practice Location Address
  12. Provider Business Practice Location Address City Name
  13. Provider Business Practice Location Address State Name
  14. Provider Business Practice Location Address Postal Code
  15. Provider Business Practice Location Address Country Code If outside U S
  16. Provider Business Practice Location Address Telephone Number
  17. Provider Enumeration Date
  18. Last Update Date
  19. Authorized Official Last Name
  20. Authorized Official First Name
  21. Authorized Official Middle Name
  22. Authorized Official Title or Position
  23. Authorized Official Telephone Number
  24. Healthcare Provider Taxonomy Code 1
  25. Provider License Number 1
  26. Provider License Number State Code 1
  27. Healthcare Provider Primary Taxonomy Switch 1
  28. Is Organization Subpart
  29. Authorized Official Name Prefix Text
  30. Authorized Official Credential Text

Complete NPI Dataset

This page represents the complete record for NPI 1710029624. You can access the complete dataset, including a full list of field names, along with their values, and definitions as recorded by the NPI registry. Each field in the NPI record is explained, highlighting its significance and the possible values it can hold.

NPI: 1710029624
The middle name of the provider, if the provider is an individual.
Entity Type Code: 2
The name prefix or salutation of the provider if the provider is an individual; for example, Mr., Mrs., or Corporal.
Employer Identification Number EIN: UNAVAIL
The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.
The first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
Provider First Line Business Mailing Address: 1212 E PALM VALLEY BLVD
The first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
Provider Business Mailing Address City Name: ROUND ROCK
The city name in the mailing address of the provider being identified.
Provider Business Mailing Address State Name: TX
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
Provider Business Mailing Address Postal Code: 786643202
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
Provider Business Mailing Address Country Code If outside U S : US
The country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.
Provider Business Mailing Address Telephone Number: 5122189890
The country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.
Provider First Line Business Practice Location Address: 1212 E PALM VALLEY BLVD
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City Name: ROUND ROCK
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State Name: TX
The State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code: 786643202
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S : US
The country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number: 5122189890
The telephone number associated with the location address of the provider being identified.
Provider Enumeration Date: 2/14/2007
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date: 8/6/2008
The date that a record was last updated or changed.
Authorized Official Last Name: JORDAN
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Authorized Official First Name: PHYLLIS
The first name of the authorized official.
Authorized Official Middle Name: L.
The middle name of the authorized official.
Authorized Official Title or Position: DIRECTOR OF CLINICAL SERVICES
The title or position of the authorized official.
Authorized Official Telephone Number: 5122189890
The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code 1: 251G00000X
The 10-position telephone number of the authorized official.
Provider License Number 1: 000215600
The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
Provider License Number State Code 1: TX
The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
Healthcare Provider Primary Taxonomy Switch 1: Y
Is Organization Subpart: N
Authorized Official Name Prefix Text: MS.
Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No
Authorized Official Credential Text: RN, CCM