NPIMap

Organization Active NPI

Matagorda Episcopal Health Outreach Program

Doing business as MEHOP Primary and Behavioral Health

  • Federally Qualified Health Center (FQHC)
  • Bay City, TX
National Provider Identifier
1861741779
Registry record updated Sep 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
MATAGORDA EPISCOPAL HEALTH OUTREACH PROGRAM
Doing business as
MEHOP Primary and Behavioral Health
Practice address
1700 Golden Ave
Bay City, TX 77414-3122
Phone
(979) 245-2008
Fax
(979) 245-0744
NPI assigned
Sep 6, 2012
Last updated
Sep 13, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2023

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

Authorized official

Name
Celeste N Harrison
Title
Ceo
Phone
(979) 245-2008

Specialties & licenses 9

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary
Mental Health Counselor 101YM0800X NU
Clinical Psychologist 103TC0700X NU
Clinical Social Worker 1041C0700X NU
Optometrist 152W00000X NU
Family Medicine Physician 207Q00000X NU
Obstetrics & Gynecology Physician 207V00000X NU
Pediatrics Physician 208000000X NU
Psychiatry Physician 2084P0800X NU

Addresses

Primary practice location

1700 Golden Ave
Bay City, TX 77414-3122

Mailing address

101 Avenue F N
Bay City, TX 77414-3167
Phone (979) 245-2008

Other identifiers 1

IdentifierTypeStateIssuer
348223401MedicaidTX

Other names 1

  • MEHOP Primary and Behavioral Health Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL www.athenanet.athenahealth.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20140904001367 TX Part A Provider - Federally Qualified Health Center (FQHC) 6002853538 Practice locations: Bay City, TX
O20150715000607 TX Part A Provider - Federally Qualified Health Center (FQHC) 6002853538 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bay City, TX

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1861741779. Details of each certification follow.

Federally qualified health center certification: CCN 741858

Legal name
MATAGORDA EPISCOPAL HEALTH OUTREACH PROGRAM CORPORATION
Doing business as
VIBRANCE HEALTH PRIMARY AND BEHAVIORAL HEALTH
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Sep 3, 2014
Last certification
Sep 3, 2014
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jul 15, 2003 in TX
Enrollment address
1700 Golden Ave
Bay City, TX 77414-3122

Federally qualified health center certification: CCN 741896

Legal name
MATAGORDA EPISCOPAL HEALTH OUTREACH PROGRAM CORPORATION
Doing business as
VIBRANCE HEALTH WOMEN AND CHILDREN CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jul 15, 2015
Last certification
Jul 15, 2015
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
111 Avenue F N
Bay City, TX 77414-3167

Other NPIs with the same Medicare PAC ID 8

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory
Tax ID family
Matagorda Episcopal Health Outreach Program Corporation12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

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

Locations

10119 US 59 Hwy
Wharton, TX 77488
Phone 9792452008302

Ownership & related parties

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Tisha Zalman Individual Corporate OfficerCfo Jul 1, 2021
W-2 Managing EmployeeCfo Jul 1, 2021
Nan Harrison Individual Corporate OfficerCeo Jul 13, 2008 100%
W-2 Managing EmployeeCeo Jul 13, 2008
Corporate OfficerCeo Jul 13, 2008

Practitioners & affiliated clinicians

Practitioners 6

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": "1346889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694563200000",
    "number": "1861741779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 AVENUE F N",
            "city": "BAY CITY",
            "state": "TX",
            "postal_code": "774143167",
            "telephone_number": "979-245-2008",
            "fax_number": "979-217-8829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 GOLDEN AVE",
            "city": "BAY CITY",
            "state": "TX",
            "postal_code": "774143122",
            "telephone_number": "979-245-2008",
            "fax_number": "979-245-0744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATAGORDA EPISCOPAL HEALTH OUTREACH PROGRAM",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-06",
        "last_updated": "2023-09-13",
        "certification_date": "2023-06-19",
        "status": "A",
        "authorized_official_last_name": "HARRISON",
        "authorized_official_first_name": "CELESTE",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "979-245-2008"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "348223401",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.athenanet.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "EMR",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Website",
            "address_1": "1700 Golden Ave",
            "city": "Bay City",
            "state": "TX",
            "country_code": "US",
            "postal_code": "774143122",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "MEHOP Primary and Behavioral Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MEHOP Primary and Behavioral Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bay City, TX

Sources for this page

Verify at the official NPI Registry.