Individual provider Active NPI

Alicia G. Fletcher, ACNS-BC

  • Adult Health Clinical Nurse Specialist
  • Odessa, TX
National Provider Identifier
1003119280
Registry record updated Dec 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Clinical Nurse SpecialistTaxonomy code 364SA2200X
License
AP119758 Issued in TX
Practice address
500 W 4TH St
Odessa, TX 79761
Phone
(432) 640-2128
Fax
(432) 640-2428
NPI assigned
Dec 10, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 23, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Clinical Nurse Specialist 364SA2200X AP119758 TX Primary

Addresses

Primary practice location

500 W 4TH St
Odessa, TX 79761

Mailing address

PO Box 2129
Odessa, TX 79760-2129
Phone (432) 640-2434

Other identifiers 1

IdentifierTypeStateIssuer
365324801MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111024000757 TX Practitioner - Certified Clinical Nurse Specialist (CNS) 3072784925 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Clinical Nurse Specialist (CNS)
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MCH Professional Care Hospital BasedGroup PAC ID 1557535127, 81 clinicians

Practice addresses (Care Compare)

500 W 4TH St
Odessa, TX 79761-5001
Phone (432) 640-2401

Hospital & facility affiliations

  • Medical Center Hospital Hospital, Odessa, TX, CCN 450132

Merit-based Incentive Payment System (MIPS)

Final score
81.41 of 100Reported as group
Quality
72.52
Improvement activities
40
Cost
81.49

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
MCH Professional Care Hospital Based CurrentSince Dec 1, 2022 Accepting new patients
Ector County Hospital District Past Accepting new patients

Locations

8050 E Highway 191
Ste 103
Odessa, TX 79765
Phone (432) 640-2128

500 W 4th St
Odessa, TX 79761
Phone (432) 640-1000

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1291939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671753600000",
    "number": "1003119280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2129",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797602129",
            "telephone_number": "432-640-2434",
            "fax_number": "432-640-2428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W 4TH ST",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "79761",
            "telephone_number": "432-640-2128",
            "fax_number": "432-640-2428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLETCHER",
        "first_name": "ALICIA",
        "middle_name": "G.",
        "credential": "ACNS-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-12-10",
        "last_updated": "2022-12-23",
        "certification_date": "2022-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SA2200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Adult Health",
            "state": "TX",
            "license": "AP119758",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "365324801",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Odessa, TX

Sources for this page

Verify at the official NPI Registry.