NPIMap

Organization Active NPI

Trinity Family Practice & Urgent Care LLC

  • Family Medicine Physician
  • Odessa, TX
National Provider Identifier
1750869194
Registry record updated Jul 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
TRINITY FAMILY PRACTICE & URGENT CARE LLC
Practice address
6110 Eastridge Rd
Odessa, TX 79762-5002
Phone
(432) 238-5076
NPI assigned
Jul 28, 2018
Last updated
Jul 28, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2018

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

Authorized official

Name
Mr. Jason PayneNPI 1497580609
Title
President
Phone
(432) 238-5076

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

6110 Eastridge Rd
Odessa, TX 79762-5002

Mailing address

PO Box 14925
Odessa, TX 79768-4925
Phone (432) 238-5076

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190318000282 TX Part B Supplier - Clinic/Group Practice 4789924432 Receives reassigned benefits from 6 practitioners
Practice locations: Odessa, TX

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/18606/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 9

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": "1532736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1532736000000",
    "number": "1750869194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14925",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797684925",
            "telephone_number": "432-238-5076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6110 EASTRIDGE RD",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797625002",
            "telephone_number": "432-238-5076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRINITY FAMILY PRACTICE & URGENT CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-28",
        "last_updated": "2018-07-28",
        "status": "A",
        "authorized_official_last_name": "PAYNE",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "432-238-5076",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jul 28, 2018; 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.