NPIMap

Organization Active NPI

MCH Professional Care

  • Anesthesiology Physician
  • Odessa, TX
National Provider Identifier
1740458207
Registry record updated Apr 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
MCH PROFESSIONAL CARE
Practice address
500 W 4TH St
Odessa, TX 79761-5001
Phone
(432) 640-2401
NPI assigned
Feb 18, 2008
Organization subpart
Yes
Parent organization
MCH PROFESSIONAL CAREAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 1, 2009

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

Authorized official

Name
Jennifer Ellen Conway
Title
Assistant Director
Phone
(432) 640-2401

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X Primary

Addresses

Primary practice location

500 W 4TH St
Odessa, TX 79761-5001

Mailing address

PO Box 643
Indianapolis, IN 46206-0643
Phone (432) 640-2401

Other identifiers 2

IdentifierTypeStateIssuer
197485901MedicaidTX
0065JHOtherTXBLUE CROSS BLUE SHIELD

Other names 1

  • MCH Professional Care Anesthesia Doing business as

National Provider Directory

National Provider Directory

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 9

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": "1203292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1238544000000",
    "number": "1740458207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 643",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462060643",
            "telephone_number": "432-640-2401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W 4TH ST",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797615001",
            "telephone_number": "432-640-2401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCH PROFESSIONAL CARE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MCH PROFESSIONAL CARE",
        "enumeration_date": "2008-02-18",
        "last_updated": "2009-04-01",
        "status": "A",
        "authorized_official_last_name": "CONWAY",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "ELLEN",
        "authorized_official_title_or_position": "ASSISTANT DIRECTOR",
        "authorized_official_telephone_number": "432-640-2401"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "197485901",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0065JH",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MCH Professional Care Anesthesia",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Odessa, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.