Individual provider Active NPI

Mayra Villa, FNP-C

  • Family Nurse Practitioner
  • Odessa, TX
National Provider Identifier
1548972763
Registry record updated Feb 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1100721 Issued in TX
Practice address
3001 JBS Pkwy
Odessa, TX 79762-8126
Phone
(432) 640-6700
Fax
(432) 640-4700
NPI assigned
Dec 19, 2022
Last updated
Feb 6, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1100721 TX Primary

Addresses

Primary practice location

3001 JBS Pkwy
Odessa, TX 79762-8126

Mailing address

PO Box 2129
Odessa, TX 79760-2129
Phone (432) 640-2401

Other practice location 1

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

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
I20230218000322 TX Practitioner - Nurse Practitioner 5597137653 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ector County Hospital DistrictGroup PAC ID 5496657769, 29 clinicians
MCH Professional CareGroup PAC ID 1658358635, 51 clinicians

Practice addresses (Care Compare)

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

8050 E Hwy 191
Suite 104B
Odessa, TX 79765-8614
Phone (432) 640-6479

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.78 of 100Reported as group
Quality
60.9
Promoting interoperability
100
Improvement activities
40
Cost
66.21

Merit-based Incentive Payment System (MIPS)

Final score
87.63 of 100Reported as group
Quality
83.96
Promoting interoperability
100
Improvement activities
40
Cost
69.97

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1100721TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ector County Hospital District Current Accepting new patients
Ector County Hospital District CurrentSince Feb 1, 2023 Accepting new patients
Ector County Hospital District CurrentSince Feb 1, 2023 Accepting new patients
MCH Professional Care CurrentSince Feb 1, 2023 Accepting new patients

Locations

3001 John Ben Shepperd Pkwy
Odessa, TX 79762
Phone (432) 640-6700

315 Golder Ave
Ste B
Odessa, TX 79761
Phone (432) 332-2695

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

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

8050 E Highway 191
Ste 104B
Odessa, TX 79765
Phone (432) 640-6479

Organizations & group practices 5

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

Hospital & facility affiliations 3

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": "1671408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675641600000",
    "number": "1548972763",
    "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": "432-640-2401",
            "fax_number": "432-640-4606"
        },
        {
            "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": {
        "last_name": "VILLA",
        "first_name": "MAYRA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-19",
        "last_updated": "2023-02-06",
        "certification_date": "2023-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1100721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Odessa, TX

Sources for this page

Verify at the official NPI Registry.