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MEMORIAL MEDICAL CENTER
NPI 1053964742
Clinic/Center - Rural Health in Port Lavaca, TX

Active since July 22, 2019CLIA Certified · 2 labs
815 N VIRGINIA ST FL 2, PORT LAVACA, TX 77979(361) 552-0379(361) 500-6904 Get Directions Write a Review

NPPES record last updated: September 19, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 19, 2025, Jul 22, 2019 (2 updates tracked since 2019).

About Memorial Medical Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MEMORIAL MEDICAL CENTER (NPI 1053964742), doing business as Memorial Medical Clinic Hospital Campus, is a healthcare organization registered as a rural health in Port Lavaca, Texas and active in the NPI registry since July 2019. The organization holds 2 active CLIA laboratory certificates and lists Erin Clevenger, Ceo, as its authorized official.

NPPES Registry Identity

NPI1053964742
Entity TypeOrganization
Primary Taxonomy261QR1300X
Legal Business NameMEMORIAL MEDICAL CENTER
Location Address815 N VIRGINIA ST FL 2Port Lavaca, TX 77979-3025
Mailing Address815 N Virginia StPort Lavaca, TX 77979-3025 · (361) 552-0325
Phone(361) 552-0379
Fax(361) 500-6904
Organization SubpartYes
Authorized OfficialErin ClevengerCeo · (361) 552-6713
Enumeration DateJuly 22, 2019
Last NPPES UpdateSeptember 19, 20252 updates tracked since enumeration
NPPES CertifiedSeptember 19, 2025
✔ NPI 1053964742 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 5

★ Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities
Taxonomy Code261QR1300X
Also ListedFamily MedicineTaxonomy 207Q00000X
Also ListedObstetrics & GynecologyTaxonomy 207V00000X
Also ListedGeneral PracticeTaxonomy 208D00000X
Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X
815 N VIRGINIA ST FL 2, Port Lavaca, TX 77979
Open in Google Maps ↗

Other Names 1

Doing Business AsMemorial Medical Clinic Hospital Campus

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 45D2054209

Memorial Medical Clinic · Port Lavaca, TX
Active · expires Feb 14, 2027
CLIA Number45D2054209
Laboratory TypePhysician Office
Certificate Effective DateFebruary 15, 2025
Certificate Expiration DateFebruary 14, 2027
Laboratory DirectorWilliam J. Crowley
Laboratory Phone(361) 552-0325
Laboratory LocationMemorial Medical Clinic1016 N Virginia, Port Lavaca, TX 77979
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Compliance 45D0054055

Memorial Medical Center · Port Lavaca, TX
Active · expires Apr 11, 2027
CLIA Number45D0054055
Laboratory TypeHospital
Certificate Effective DateApril 12, 2025
Certificate Expiration DateApril 11, 2027
Laboratory DirectorBryan Janssen
Laboratory Phone(361) 552-0284
Laboratory LocationMemorial Medical Center815 Virginia N Street, Port Lavaca, TX 77979
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. MERCEDES SCHULTZ MD
Obstetrics & Gynecology
815 N VIRGINIA ST FL 2
PORT LAVACA, TX 77979
Calhoun County (361) 552-0325
MICHAEL LEON GAINES FNP-C
Nurse Practitioner (Family)
815 N VIRGINIA ST FL 2
PORT LAVACA, TX 77979
Calhoun County (361) 552-0379
DR. JERRY LEE FOLLOWWILL M.D.
Orthopaedic Surgery
815 N VIRGINIA ST FL 2
PORT LAVACA, TX 77979
Calhoun County (361) 552-0379

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Memorial Medical Center's NPI number?

The NPI number for Memorial Medical Center is 1053964742. It was assigned to this organization in the NPPES registry on July 22, 2019. The provider is doing business as Memorial Medical Clinic Hospital Campus.

Where is Memorial Medical Center located?

Memorial Medical Center is located at 815 N Virginia St Fl 2, Port Lavaca, TX 77979. The listed phone number is (361) 552-0379.

What is Memorial Medical Center's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rural Health, with taxonomy code 261QR1300X.

Does Memorial Medical Center hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

What insurance does Memorial Medical Center accept?

Health plans from Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 1 other insurer list Memorial Medical Center as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Memorial Medical Center was last updated on September 19, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.