NPIMap

Organization Active NPI

El Campo Memorial Hospital

  • General Practice Physician
  • El Campo, TX
National Provider Identifier
1699294165
Registry record updated Oct 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
EL CAMPO MEMORIAL HOSPITAL
Practice address
3703 FM 2765 Rd
El Campo, TX 77437-6399
Phone
(979) 543-6251
NPI assigned
Sep 15, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2022

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

Authorized official

Name
Anita Crisp
Title
Clinic Director
Phone
(979) 543-5510

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

3703 FM 2765 Rd
El Campo, TX 77437-6399

Mailing address

305 Sandy Corner Rd
El Campo, TX 77437-9535

Other names 1

  • Mid Coast Well Care - El Campo Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140813001385 TX Part B Supplier - Clinic/Group Practice 6406021765 Receives reassigned benefits from 38 practitioners
23 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Wharton, TX; Palacios, TX; Mason, TX; Louise, TX; Ganado, TX; El Campo, TX; Boling, TX; Blessing, TX…

Other NPIs on the same Medicare enrollment 23

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

View all 23

National Provider Directory

National Provider Directory
Tax ID family
El Campo Memorial Hospital27 organizations share this tax ID, including this one

Other organizations with this tax ID 26

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

View all 26

Locations

3703 FM 2765 Rd
El Campo, TX 77437
Phone (979) 543-6251

Practitioners & affiliated clinicians

Practitioners 2

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": "1505433600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666051200000",
    "number": "1699294165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 SANDY CORNER RD",
            "city": "EL CAMPO",
            "state": "TX",
            "postal_code": "774379535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3703 FM 2765 RD",
            "city": "EL CAMPO",
            "state": "TX",
            "postal_code": "774376399",
            "telephone_number": "979-543-6251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EL CAMPO MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-15",
        "last_updated": "2022-10-18",
        "certification_date": "2022-10-18",
        "status": "A",
        "authorized_official_last_name": "CRISP",
        "authorized_official_first_name": "ANITA",
        "authorized_official_title_or_position": "CLINIC DIRECTOR",
        "authorized_official_telephone_number": "979-543-5510"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mid Coast Well Care - El Campo",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in El Campo, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.