NPIMap

Organization Active NPI

Methodist Hospital Levelland

Doing business as Covenant Hospital Levelland

  • Emergency Medicine Physician
  • Levelland, TX
National Provider Identifier
1043328222
Registry record updated May 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
000307 Issued in TX
Legal business name
METHODIST HOSPITAL LEVELLAND
Doing business as
Covenant Hospital Levelland
Practice address
1900 College Ave
Levelland, TX 79336
Phone
(806) 894-4963
Fax
(806) 894-6461
NPI assigned
Aug 28, 2006
Last updated
May 6, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
METHODIST HOSPITAL LEVELLANDAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 6, 2025

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

Authorized official

Name
Donald W Anderson Jr.
Title
Assistant Secretary of Enrollments
Phone
(425) 358-9786

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207P00000X 000307 TX Primary

Addresses

Primary practice location

1900 College Ave
Levelland, TX 79336

Mailing address

PO Box 677044
Dallas, TX 75267-7044
Phone (806) 894-4963

Other identifiers 2

IdentifierTypeStateIssuer
103182100OtherTXFIRSTCARE/SWL&H/CHIPS
13325870502MedicaidTX

Other names 1

  • COVENANT HOSPITAL LEVELLAND Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040607001572 TX Part B Supplier - Clinic/Group Practice 8527041037 Receives reassigned benefits from 16 practitioners
Practice locations: Levelland, TX

Other NPIs with the same Medicare PAC ID 5

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

National Provider Directory

National Provider Directory
Part of
Levelland Clinic North

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 18

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.

View all 18

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746489600000",
    "number": "1043328222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 677044",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752677044",
            "telephone_number": "806-894-4963",
            "fax_number": "806-894-6461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 COLLEGE AVE",
            "city": "LEVELLAND",
            "state": "TX",
            "postal_code": "79336",
            "telephone_number": "806-894-4963",
            "fax_number": "806-894-6461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METHODIST HOSPITAL LEVELLAND",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "METHODIST HOSPITAL LEVELLAND",
        "enumeration_date": "2006-08-28",
        "last_updated": "2025-05-06",
        "certification_date": "2025-05-06",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "ASSISTANT SECRETARY OF ENROLLMENTS",
        "authorized_official_telephone_number": "425-358-9786",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "000307",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRSTCARE/SWL&H/CHIPS",
            "identifier": "103182100",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "13325870502",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "COVENANT HOSPITAL LEVELLAND",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "COVENANT HOSPITAL LEVELLAND",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Levelland, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2025; 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.