MEDICARE: CHG HOSPITAL AUSTIN, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	207R00000X	Internal Medicine Physician
2	261QA1903X	Ambulatory Surgical Clinic/Center
3	282E00000X	Long Term Care Hospital

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1912395203
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHG HOSPITAL AUSTIN, LLC

Provider Business Mailing Address
First Line	:	680 S 4TH ST
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40202-2407
Country	:	US
Telephone Number	:	502-596-6063
Fax Number	:	502-212-8481

Provider Business Practice Location Address
First Line	:	4681 COLLEGE PARK DR
Second Line	:
City	:	ROUND ROCK
State	:	TX
Zip	:	78665-1526
Country	:	US
Telephone Number	:	512-671-1100
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	JOHNETTA TRAYLOR
Credential	:
Telephone Number	:	502-596-6063

Provider Enumeration Date	:	01/08/2015
Last Update Date	:	10/08/2025

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