NPIMap

Organization Active NPI

Compass Pediatrics, PLLC

  • Primary Care Clinic/Center
  • Odessa, TX
National Provider Identifier
1306152103
Registry record updated Apr 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
657564 Issued in TX
Legal business name
COMPASS PEDIATRICS, PLLC
Practice address
6100 Eastridge Rd
Odessa, TX 79762-5002
Phone
(432) 332-2080
Fax
(866) 298-7237
NPI assigned
Aug 31, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2014

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

Authorized official

Name
Dr. Tamara Rachelle Bavousett, DNP, RN, C-PNPNPI 1427272749
Title
Nurse Practitioner/Owner
Phone
(432) 332-2080

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 657564 TX Primary

Addresses

Primary practice location

6100 Eastridge Rd
Odessa, TX 79762-5002

Mailing address

6100 Eastridge Rd
Odessa, TX 79762-5002
Phone (432) 332-2080

Other identifiers 1

IdentifierTypeStateIssuer
214730801MedicaidTX

National Provider Directory

National Provider Directory

Locations

5113 Wayland Dr
Odessa, TX 79762
Phone (432) 332-2080

6100 Eastridge Rd
Odessa, TX 79762
Phone (432) 332-2080

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1283212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1396310400000",
    "number": "1306152103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6100 EASTRIDGE RD",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797625002",
            "telephone_number": "432-332-2080",
            "fax_number": "866-298-7237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6100 EASTRIDGE RD",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797625002",
            "telephone_number": "432-332-2080",
            "fax_number": "866-298-7237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPASS PEDIATRICS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-31",
        "last_updated": "2014-04-01",
        "status": "A",
        "authorized_official_last_name": "BAVOUSETT",
        "authorized_official_first_name": "TAMARA",
        "authorized_official_middle_name": "RACHELLE",
        "authorized_official_title_or_position": "NURSE PRACTITIONER/OWNER",
        "authorized_official_telephone_number": "432-332-2080",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DNP, RN, C-PNP"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "TX",
            "license": "657564",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "214730801",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Odessa, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.