NPIMap

Organization Active NPI

Ector County Hospital District

Doing business as MCH Urgent Care

  • Urgent Care Clinic/Center
  • Odessa, TX
National Provider Identifier
1366680555
Registry record updated Sep 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
ECTOR COUNTY HOSPITAL DISTRICT
Doing business as
MCH Urgent Care
Practice address
3001 JBS Pkwy
Odessa, TX 79762-8126
Phone
(432) 640-6700
Fax
(432) 640-4700
NPI assigned
Jan 27, 2009
Last updated
Sep 11, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
ECTOR COUNTY HOSPITAL DISTRICTAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 11, 2023

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

Authorized official

Name
Mr. Russell Tippen
Title
Ceo
Phone
(432) 640-2413

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X NU Primary

Addresses

Primary practice location

3001 JBS Pkwy
Odessa, TX 79762-8126

Mailing address

PO Box 7239
Odessa, TX 79760-7239
Phone (432) 640-1000

Other practice location 1

6030 W University Blvd
Odessa, TX 79764-8530
Phone (432) 640-6600

Other identifiers 1

IdentifierTypeStateIssuer
135235302MedicaidTX

Other names 1

  • MCH Urgent Care Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040412001222 TX Part B Supplier - Clinic/Group Practice 5496657769 Receives reassigned benefits from 49 practitioners
4 other NPIs on this enrollment
Practice locations: Odessa, TX

Other NPIs with the same Medicare PAC ID 6

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Medical Center Hospital ER

Locations

6030 W University Blvd
Odessa, TX 79764
Phone (432) 640-6600

Ownership & related parties

All facility ownership & control disclosures 6

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Medical Center HospitalOdessa, TX, CCN 450132 Hospital 5% Or Greater Direct Ownership Interest Jan 1, 1975
Encompass Health Rehabilitation Hospital of Midland OdessaMidland, TX, CCN 453057 Hospital 5% Or Greater Indirect Ownership Interest (17%) Jul 1, 2021
Family Health ClinicOdessa, TX, CCN 671912 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2006
Family Health ClinicOdessa, TX, CCN 741933 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Oct 1, 2014
MCH Family Health ClinicOdessa, TX, CCN 451162 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2021
MCH Family Health ClinicOdessa, TX, CCN 671081 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Mar 1, 2023

Owned or controlled facilities with NPI records 6

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 152

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 152

NPI Registry JSON

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

{
    "created_epoch": "1233014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694390400000",
    "number": "1366680555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7239",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797607239",
            "telephone_number": "432-640-1000",
            "fax_number": "432-640-1898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 JBS PKWY",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797628126",
            "telephone_number": "432-640-6700",
            "fax_number": "432-640-4700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6030 W University Blvd",
            "address_purpose": "LOCATION",
            "city": "Odessa",
            "state": "TX",
            "postal_code": "797648530",
            "country_code": "US",
            "telephone_number": "432-640-6600",
            "fax_number": "432-640-4790",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ECTOR COUNTY HOSPITAL DISTRICT",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ECTOR COUNTY HOSPITAL DISTRICT",
        "enumeration_date": "2009-01-27",
        "last_updated": "2023-09-11",
        "certification_date": "2023-09-11",
        "status": "A",
        "authorized_official_last_name": "TIPPEN",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "432-640-2413",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "135235302",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MCH Urgent Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Odessa, TX

Sources for this page

Verify at the official NPI Registry.