MEMORIAL MEDICAL CLINIC
NPI 1497153589
Clinic/Center - Rural Health in Port Lavaca, TX

Active since December 05, 2014CLIA Certified · 2 labs
1016 N VIRGINIA ST, PORT LAVACA, TX 77979(361) 552-0325(361) 500-6904 Get Directions Write a Review

NPPES record last updated: October 30, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Memorial Medical Clinic NPPES

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

MEMORIAL MEDICAL CLINIC (NPI 1497153589) is a healthcare organization registered as a rural health in Port Lavaca, Texas and active in the NPI registry since December 2014. The organization holds 2 active CLIA laboratory certificates and lists Erin Clevenger, Ceo, as its authorized official.

NPPES Registry Identity

NPI1497153589
Entity TypeOrganization
Primary Taxonomy261QR1300X
Legal Business NameMEMORIAL MEDICAL CENTER
Location Address1016 N VIRGINIA STPort Lavaca, TX 77979-3000
Mailing Address815 N Virginia StPort Lavaca, TX 77979-3025 · (361) 552-6713 · Fax (361) 552-0220
Fax(361) 500-6904
Organization SubpartNo
Authorized OfficialErin ClevengerCeo · (361) 552-6713
Enumeration DateDecember 5, 2014
Last NPPES UpdateOctober 30, 2024
NPPES CertifiedOctober 30, 2024
NPI 1497153589 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 6

Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities
Taxonomy Code261QR1300X
Also ListedFamily MedicineTaxonomy 207Q00000X
Also ListedInternal MedicineTaxonomy 207R00000X
Also ListedObstetrics & GynecologyTaxonomy 207V00000X
Also ListedPediatricsTaxonomy 208000000X
Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X
1016 N VIRGINIA ST, Port Lavaca, TX 77979

Other Names 1

Doing Business AsMemorial Medical Clinic

Other Identifiers 2

Medicaid137909112TX
Other673422TX · Medicare Rhc

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

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 45D2172411

Memorial Medical Clinic Hospital Campus · Port Lavaca, TX
Active · expires Sep 22, 2027
CLIA Number45D2172411
Laboratory TypeRural Health Clinic
Certificate Effective DateSeptember 23, 2025
Certificate Expiration DateSeptember 22, 2027
Laboratory DirectorWilliam J. Crowley
Laboratory Phone(361) 552-0379
Laboratory LocationMemorial Medical Clinic Hospital Campus815 N Virginia Street, Floor 2, Port Lavaca, TX 77979
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Compliance 45D2099521

Memorial Medical Clinic Laboratory · Port Lavaca, TX
Active · expires Aug 10, 2026
CLIA Number45D2099521
Laboratory TypeRural Health Clinic
Certificate Effective DateAugust 11, 2024
Certificate Expiration DateAugust 10, 2026
Laboratory DirectorBryan Janssen
Laboratory Phone(361) 552-0284
Laboratory LocationMemorial Medical Clinic Laboratory1016 N Virginia Street, Port Lavaca, TX 77979
CLIA data matches this NPI record on: Address 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 12

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

Physician Assistant (Medical)
1016 N VIRGINIA ST
PORT LAVACA, TX 77979
Nurse Practitioner (Family)
1016 N VIRGINIA ST
PORT LAVACA, TX 77979
Nurse Practitioner (Family)
1016 N VIRGINIA ST
PORT LAVACA, TX 77979
Family Medicine
1016 N VIRGINIA ST
PORT LAVACA, TX 77979
Nurse Practitioner (Family)
1016 N VIRGINIA ST
PORT LAVACA, TX 77979
Pediatrics
1016 N VIRGINIA ST
PORT LAVACA, TX 77979
Family Medicine
1016 N VIRGINIA ST
PORT LAVACA, TX 77979
Nurse Practitioner (Family)
1016 N VIRGINIA ST
PORT LAVACA, TX 77979

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 1497153589. It was assigned to this organization in the NPPES registry on December 5, 2014. The provider is doing business as Memorial Medical Clinic.

Where is Memorial Medical Center located?

Memorial Medical Center is located at 1016 N Virginia St, Port Lavaca, TX 77979. The listed phone number is (361) 552-0325.

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 3 other insurers 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 October 30, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.