NPIMap

Organization Active NPI

Coastal Bend Urgent Care, LLC

Doing business as Beeville Medical Clinic

  • Urgent Care Clinic/Center
  • Beeville, TX
National Provider Identifier
1427509264
Registry record updated Aug 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
COASTAL BEND URGENT CARE, LLC
Doing business as
Beeville Medical Clinic
Practice address
301 S Hillside Dr Ste 4
Beeville, TX 78102-5324
Phone
(361) 542-4076
NPI assigned
Oct 17, 2016
Last updated
Aug 15, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2019

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

Authorized official

Name
Mercedita FlynnNPI 1619166188
Title
Owner
Phone
(713) 893-6214

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X Primary
Family Nurse Practitioner 363LF0000X AP118292 TX

Addresses

Primary practice location

301 S Hillside Dr Ste 4
Beeville, TX 78102-5324

Mailing address

301 S Hillside Dr Ste 4
Beeville, TX 78102-5324
Phone (713) 893-6214

Other practice location 1

504A Houston St
George West, TX 78022-3663
Phone (361) 226-1219

Other names 1

  • Beeville Medical Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170817000663 TX Part B Supplier - Clinic/Group Practice 9335411982 Receives reassigned benefits from 7 practitioners
1 other NPI on this enrollment
Practice locations: Beeville, TX; George West, TX

Other NPIs on the same Medicare enrollment 1

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2132336Beeville Medical Clinic301 S Hillside Drive, Suite 4, Beeville, TX 78102Certificate of waiverJun 15, 2027

National Provider Directory

National Provider Directory
Tax ID family
Coastal Bend Urgent Care LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

301 S Hillside Dr
Beeville, TX 78102
Phone (301) 358-3535

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1476662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1565827200000",
    "number": "1427509264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 S HILLSIDE DR STE 4",
            "city": "BEEVILLE",
            "state": "TX",
            "postal_code": "781025324",
            "telephone_number": "713-893-6214",
            "fax_number": "718-640-2713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 S HILLSIDE DR STE 4",
            "city": "BEEVILLE",
            "state": "TX",
            "postal_code": "781025324",
            "telephone_number": "361-542-4076"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "504A Houston St",
            "address_purpose": "LOCATION",
            "city": "George West",
            "state": "TX",
            "postal_code": "780223663",
            "country_code": "US",
            "telephone_number": "361-226-1219",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "COASTAL BEND URGENT CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-17",
        "last_updated": "2019-08-15",
        "status": "A",
        "authorized_official_last_name": "FLYNN",
        "authorized_official_first_name": "MERCEDITA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "713-893-6214"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP118292",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Beeville Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Beeville Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Beeville, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.