NPIMap

Organization Active NPI

El Campo Memorial Hospital

  • Rural Health Clinic/Center
  • El Campo, TX
National Provider Identifier
1992394175
Registry record updated Dec 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
EL CAMPO MEMORIAL HOSPITAL
Practice address
1201 N Mechanic St
El Campo, TX 77437-2613
Phone
(979) 543-5510
NPI assigned
Jan 13, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2024

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

Authorized official

Name
Brett Kirkham
Title
Ceo
Phone
(979) 543-6251

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

1201 N Mechanic St
El Campo, TX 77437-2613

Mailing address

305 Sandy Corner Rd
El Campo, TX 77437-9535
Phone (979) 543-5510

Medicare participation

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

Enrollment records 2

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…
O20200414000274 TX Part A Provider - Rural Health Clinic 6406021765 1 other NPI on this enrollment
Practice locations: El Campo, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1992394175. Details of each certification follow.

Rural health clinic certification: CCN 673478

Legal name
EL CAMPO MEMORIAL HOSPITAL
Doing business as
MID COAST WELL CARE
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jan 29, 2020
Last certification
Jan 6, 2026
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Jun 20, 2011 in TX
Enrollment address
1201 N Mechanic St
El Campo, TX 77437-2603
Related CCNs
450694

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 4

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

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

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
David Mak Individual Corporate DirectorChief Financial Officer Aug 1, 2017
W-2 Managing EmployeeChief Financial Officer Aug 1, 2017
Carrie Cornett Individual Corporate DirectorChief Financial Officer Jul 20, 2025
W-2 Managing EmployeeChief Financial Officer Jul 20, 2025
El Campo Memorial Hospital Organization, El Campo, TX Corporation, Medical provider/supplier, Non-profit 5% Or Greater Direct Ownership Interest Jun 3, 2019 100%
Operational/Managerial Control Jun 3, 2019 100%
Brett Kirkham Individual Corporate DirectorChief Executive Officer Oct 1, 2023
W-2 Managing EmployeeChief Executive Officer Oct 1, 2023

Owners & managing parties with NPI records 4

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

  • El Campo Memorial Hospital

    dba Mid Coast Medical Clinic - Trinity

    • General Acute Care Hospital
    • El Campo, TX
    • NPI 1003192311

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • El Campo Memorial Hospital
    • Rural Health Clinic/Center
    • El Campo, TX
    • NPI 1427334077

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • El Campo Memorial Hospital

    dba Mid Coast Medical Center

    • Rural Health Clinic/Center
    • Wharton, TX
    • NPI 1518465616

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • El Campo Memorial Hospital

    dba El Campo Memorial Hospital Swing Bed

    • Medicare Defined Swing Bed Hospital Unit
    • El Campo, TX
    • NPI 1720364037

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
El Campo Memorial HospitalEl Campo, TX, CCN 450694 Hospital 5% Or Greater Direct Ownership Interest
Operational/Managerial Control		 Apr 11, 2014
Apr 11, 2014
El Campo Memorial HospitalEl Campo, TX, CCN 45U694 Hospital 5% Or Greater Direct Ownership Interest
Operational/Managerial Control		 Apr 11, 2014
Apr 11, 2014
Mid Coast Medical ClinicEl Campo, TX, CCN 453463 Rural health clinic 5% Or Greater Direct Ownership Interest
Operational/Managerial Control		 Apr 11, 2014
Apr 11, 2014
El Campo Memorial HospitalWharton, TX, CCN 673466 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jan 25, 2018
Jan 25, 2018

Owned or controlled facilities with NPI records 5

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

  • El Campo Memorial Hospital

    dba Mid Coast Medical Clinic - Trinity

    • General Acute Care Hospital
    • El Campo, TX
    • NPI 1003192311

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • El Campo Memorial Hospital
    • Rural Health Clinic/Center
    • El Campo, TX
    • NPI 1427334077

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • El Campo Memorial Hospital

    dba Mid Coast Medical Center

    • Rural Health Clinic/Center
    • Wharton, TX
    • NPI 1518465616

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • El Campo Memorial Hospital

    dba MidCoast WellCare

    • Rural Health Clinic/Center
    • El Campo, TX
    • NPI 1538624143

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • El Campo Memorial Hospital

    dba El Campo Memorial Hospital Swing Bed

    • Medicare Defined Swing Bed Hospital Unit
    • El Campo, TX
    • NPI 1720364037

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership

Facilities with the same owner 4

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 1

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": "1610496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734048000000",
    "number": "1992394175",
    "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",
            "telephone_number": "979-543-5510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 N MECHANIC ST",
            "city": "EL CAMPO",
            "state": "TX",
            "postal_code": "774372613",
            "telephone_number": "979-543-5510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EL CAMPO MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-13",
        "last_updated": "2024-12-13",
        "certification_date": "2024-12-13",
        "status": "A",
        "authorized_official_last_name": "KIRKHAM",
        "authorized_official_first_name": "BRETT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "979-543-6251"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Campo, TX

Sources for this page

Verify at the official NPI Registry.