Individual provider Active NPI

Mary Grace Bridges, MD

  • Obstetrics & Gynecology Physician
  • Odessa, TX
National Provider Identifier
1609133362
Registry record updated Feb 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
Q7016 Issued in TX
Practice address
601 N Tom Green Ave
Odessa, TX 79761-4525
Phone
(432) 332-0090
Fax
(833) 908-2112
NPI assigned
Apr 19, 2012
Last updated
Feb 21, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X Q7016 TX Primary

Addresses

Primary practice location

601 N Tom Green Ave
Odessa, TX 79761-4525

Mailing address

601 N Tom Green Ave
Odessa, TX 79761-4525
Phone (432) 332-0090

Other identifiers 4

IdentifierTypeStateIssuer
200654770 AMedicaidOK
93505264MedicaidNM
356781002MedicaidTX
356781001MedicaidTX

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160712000617 TX Practitioner - Obstetrics/Gynecology 3274825211 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

421 E 7TH St
Odessa, TX 79761-4562
Phone (432) 332-0090

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
Q7016TXMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Tech University Health Sciences Center Amarillo Current Accepting new patients
Permian Women's Center, P.a Obstetrics & Gynecology CurrentSince Jan 13, 2025 Accepting new patients
Texas Tech University Health Sciences Center Amarillo Obstetrics & Gynecology CurrentSince Aug 1, 2016 Accepting new patients
Obhg Texas Holdings, P.a. Obstetrics & Gynecology CurrentSince Jan 27, 2020 Accepting new patients
Texas Tech University Health Sciences Center Odessa Obstetrics & Gynecology Current Accepting new patients
Texas Tech University Health Sciences Center CurrentSince Aug 1, 2016 Accepting new patients
Womens Wellness of West Texas Obstetrics & Gynecology CurrentSince Aug 28, 2021 Accepting new patients
Odessa Texas Hospital Company LLC Past Accepting new patients
Ector County Hospital District Past Accepting new patients
Odessa Regional Hospital LP Past Accepting new patients

Locations

1400 S Coulter St
Amarillo, TX 79106
Phone (806) 354-5600

1400 Wallace Blvd
Amarillo, TX 79106
Phone (806) 354-5585

5950 Saratoga Blvd
Corpus Christi, TX 78414
Phone (361) 985-5000

4015 22nd Pl
Lubbock, TX 79410
Phone (806) 725-0000

405 N Tom Green Ave
Odessa, TX 79761
Phone (432) 580-8976

617 N Tom Green Ave
Odessa, TX 79761
Phone (432) 333-2229

617 N Tom Green Ave
Ste B
Odessa, TX 79761
Phone (432) 332-0090

701 W 5th St
Odessa, TX 79763
Phone (432) 335-2222

701 W 5th St
#3142
Odessa, TX 79763
Phone (432) 335-2222

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/abd8726a-ad55-4f85-8206-9ee9deb6ac7b/
  • Direct secure messaging: mary.grace.bridges.1@21504.direct.athenahealth.com
  • Direct secure messaging: marygracebridges@texastech.allscriptsdirect.net

Organizations & group practices 11

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 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": "1334793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708473600000",
    "number": "1609133362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 N TOM GREEN AVE",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797614525",
            "telephone_number": "432-332-0090",
            "fax_number": "833-908-2112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 N TOM GREEN AVE",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797614525",
            "telephone_number": "432-332-0090",
            "fax_number": "833-908-2112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRIDGES",
        "first_name": "MARY GRACE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-19",
        "last_updated": "2024-02-21",
        "certification_date": "2024-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TX",
            "license": "Q7016",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200654770 A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "93505264",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "356781002",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "356781001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Odessa, TX

Sources for this page

Verify at the official NPI Registry.