ROCKDALE BLACKHAWK LLC (NPI# 1699798512) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699798512 |
| Entity Type | Organization |
| Organization Name | ROCKDALE BLACKHAWK LLC |
| Other Organization Name | LITTLE RIVER HEALTHCARE ROCKDALE CLINIC |
| Practice Address |
602 N Main St Rockdale TX 76567-2323 |
| Mailing Address |
Po Box 1010 Rockdale TX 76567-1010 |
| Practice Telephone | 5124464500 |
| Practice Fax Number | 5124460084 |
| Mailing Telephone | 5124464500 |
| Mailing Fax Number | 5124460084 |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2015-02-11 |
| 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 | 261QR1300X |
Clinic/Center Specialization: Rural Health |
000369 | TX | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 111705303 | 05 |
| Other Name | Type Code |
|---|---|
| Little River Healthcare Rockdale Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073924932 | Rockdale Blackhawk LLC | Prosthetic/Orthotic Supplier | 1512 Leander Rd, Georgetown, TX 78628-8801 | 2014-05-14 |
| 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 |
| Street Address |
602 N MAIN ST |
| City | ROCKDALE |
| State | TX |
| Zip Code | 76567-2323 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699179275 | Karla Woods | Nurse Practitioner | 602 N Main St, Rockdale, TX 76567-2323 | 2014-10-10 |
| 1851638969 | Christine Griffin | Nurse Practitioner | 602 N Main St, Rockdale, TX 76567-2323 | 2013-01-09 |
| 1205084647 | Texas Cardiovascular Consultants, Pa | Internal Medicine | 602 N Main St, Rockdale, TX 76567-2323 | 2008-08-27 |
| 1023234978 | Rockdale Blackhawk LLC | Clinic/Center | 602 N Main St, Rockdale, TX 76567-2323 | 2007-04-18 |
| 1730224296 | Barbara J Dodson | Nurse Practitioner | 602 N Main St, Rockdale, TX 76567-2323 | 2007-02-21 |
| 1669518304 | Michael Paul Dennis | Counselor | 602 N Main St, Rockdale, TX 76567-2323 | 2007-01-29 |
| 1871653311 | Deborah L Bland | Social Worker | 602 N Main St, Rockdale, TX 76567-2323 | 2006-12-12 |
| 1790876795 | Karen Leigh Sieber | Licensed Practical Nurse | 602 N Main St, Rockdale, TX 76567-2323 | 2006-09-27 |
| 1134161359 | John Weed IIi | Family Medicine | 602 N Main St, Rockdale, TX 76567-2323 | 2006-06-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912372459 | Rockdale Snf LLC | Skilled Nursing Facility | 1350 W Us Highway 79, Rockdale, TX 76567 | 2015-12-09 |
| 1295125391 | Melinda Richards Catching | Speech-Language Pathologist | 123 West Cameron Ave., Rockdale, TX 76567 | 2015-01-27 |
| 1285911123 | Rockdale Blackhawk, LLC | Clinic/Center | 1700 Brazos, Suite A, B and C, Rockdale, TX 76567 | 2011-11-07 |
| 1447206669 | Christen J Leblanc | Emergency Medicine | 1700 Brazos Ave., Rockdale, TX 76567 | 2006-05-26 |
| 1316373616 | Kristi Lynn Estrada | Nurse Practitioner | 1700 Brazos, Rockdale, TX 76567 | 2013-09-18 |
| 1205309028 | Bradford Ingram | Licensed Vocational Nurse | 1800 Sager Rd, Rockdale, TX 76567-2060 | 2019-01-03 |
| 1932409786 | Malda Mayo Burns | Counselor | 1503 Skyles Rd, Rockdale, TX 76567-2074 | 2010-10-27 |
| 1740580356 | Burns Professional Services LLC | Community/Behavioral Health | 1503 Skyles Rd, Rockdale, TX 76567-2074 | 2010-10-28 |
| 1639259179 | Arboretum Health Care, Inc. | Skilled Nursing Facility | 700 Dyer St, Rockdale, TX 76567-2208 | 2006-10-17 |
| 1740559640 | Alison Parker | Speech-Language Pathologist | 700 Dyer St, Rockdale, TX 76567-2208 | 2011-12-21 |
| Find all providers in zip 76567 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285911123 | Rockdale Blackhawk, LLC | Clinic/Center | 1700 Brazos, Suite A, B and C, Rockdale, TX 76567 | 2011-11-07 |
| 1104061076 | Cameron Hospital Inc | Clinic/Center | 725 Taylor Banc Plaza Ave, Rockdale, TX 76567-2781 | 2008-12-08 |
| 1609007756 | Rockdale Blackhawk LLC | Clinic/Center | 1700 Brazos Ave, Rockdale, TX 76567-2517 | 2009-08-06 |
| 1023234978 | Rockdale Blackhawk LLC | Clinic/Center | 602 N Main St, Rockdale, TX 76567-2323 | 2007-04-18 |
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| 1588137103 | Nocona Hospital District | Clinic/Center | 108 E Boggess St, Saint Jo, TX 76265-0238 | 2019-01-07 |
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| Find all providers with the same taxonomy | ||||
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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.