NPIMap

Organization Active NPI

Dallam-Hartley Counties Hospital District

  • Rural Health Clinic/Center
  • Dalhart, TX
National Provider Identifier
1174533103
Registry record updated Apr 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
License
000262 Issued in TX
Legal business name
DALLAM-HARTLEY COUNTIES HOSPITAL DISTRICT
Practice address
206 E. 16TH St
Dalhart, TX 79022
Phone
(806) 244-5668
Fax
(806) 244-5912
NPI assigned
Aug 9, 2006
Organization subpart
Yes
Parent organization
DALLAM HARTLEY COUNTIES HOSPITAL DIST. DBA COON MEMORIAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 24, 2025

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

Authorized official

Name
Ms. Melissa Bundy
Title
Ceo
Phone
(806) 244-9267

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X 000262 TX Primary

Addresses

Primary practice location

206 E. 16TH St
Dalhart, TX 79022

Mailing address

206 E. 16TH St
Dalhart, TX 79022-4802
Phone (806) 244-5668

Other identifiers 5

IdentifierTypeStateIssuer
0019EZOtherTXBLUE CROSS BLUE SHIELD
103267102OtherTX1ST CARE
144326902OtherTXMCD TX HLTH STEPS
0019EZOtherTXBC
144326901MedicaidTX

Other names 1

  • Dalhart Family Medicine Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100603000170 TX Part A Provider - Rural Health Clinic 0143112805 Practice locations: Dalhart, TX

Rural health clinic certification: CCN 458816

Legal name
DALLAM-HARTLEY COUNTIES HOSPITAL DISTRICT
Doing business as
DALHART FAMILY MEDICINE CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jan 9, 2001
Last certification
Jul 10, 2018
Ownership / control type
Non-profit – church related
Organization structure
OtherNon-profit
Enrollment address
206 E. 16TH St
Dalhart Family Medicine Clinic
Dalhart, TX 79022-4802

Other NPIs with the same Medicare PAC ID 5

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D0998382Dalhart Family Medicine Clinic206 East 16TH Street, Dalhart, TX 79022Provider-performed microscopyApr 11, 2028

National Provider Directory

National Provider Directory
Tax ID family
Coon Memorial Hosp and9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

Member organizations 3

Organizations listed as members of this organization in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 13

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

NameRoleSinceShare
Dallam-Hartley Counties Hospital District Organization, Dalhart, TX Operational/Managerial Control Mar 1, 2010
Mark Miller Individual Corporate DirectorBoard Member Jul 1, 2016
Brad P Riley Individual Corporate DirectorBoard Member Apr 22, 2021
Brad H Green Individual Corporate DirectorBoard Member Mar 1, 2025
Sharon D Hunt Individual Contracted Managing EmployeeInterim Chief Financial Officer Jun 1, 2024
Corporate DirectorInterim Chief Financial Officer Jun 1, 2024
Operational/Managerial ControlInterim Chief Financial Officer Jun 1, 2024
Matthew S Turner Individual Corporate OfficerMedical Director Sep 1, 1996
Shellie McNabb Individual Corporate DirectorBoard President May 9, 2022
Jennifer McDaniel Individual Corporate DirectorBoard Member Mar 1, 2025
Kevin Caddell Individual Corporate DirectorVice President Sep 1, 2013
Michael Diller Individual Corporate DirectorBoard Member Apr 20, 2020
Sarah Crone Individual Corporate OfficerAdministrator Jun 1, 2024
Melissa Bundy Individual Corporate OfficerChief Executive Officer Jun 1, 2024 100%
W-2 Managing EmployeeChief Executive Officer Jun 1, 2024
Operational/Managerial ControlChief Exectuive Officer Jun 1, 2024
Nichole Crosby Individual W-2 Managing EmployeeExecutive Administrative Assistant Jan 1, 2024

Owners & managing parties with NPI records 6

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

All facility ownership & control disclosures 4

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

FacilityTypeRoleSince
Coon Memorial HospitalDalhart, TX, CCN 451331 Hospital Operational/Managerial Control Apr 1, 2002
Coon Memorial HospitalDalhart, TX, CCN 45Z331 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Jan 1, 1970
Apr 1, 2002
Coon Memorial Hospital Home CareDalhart, TX, CCN 671531 Hospice 5% Or Greater Direct Ownership Interest (100%) Nov 29, 2005
High Country Community Rural Health ClinicDalhart, TX, CCN 673409 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jun 27, 2008
Jun 27, 2008

Owned or controlled facilities with NPI records 4

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

Facilities with the same owner 4

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

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745452800000",
    "number": "1174533103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 E. 16TH ST",
            "city": "DALHART",
            "state": "TX",
            "postal_code": "790224802",
            "telephone_number": "806-244-5668",
            "fax_number": "806-244-5912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 E. 16TH ST",
            "city": "DALHART",
            "state": "TX",
            "postal_code": "79022",
            "telephone_number": "806-244-5668",
            "fax_number": "806-244-5912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DALLAM-HARTLEY COUNTIES HOSPITAL DISTRICT",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DALLAM HARTLEY COUNTIES HOSPITAL DIST. DBA COON MEMORIAL HOSPITAL",
        "enumeration_date": "2006-08-09",
        "last_updated": "2025-04-24",
        "certification_date": "2025-04-24",
        "status": "A",
        "authorized_official_last_name": "BUNDY",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "806-244-9267",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "TX",
            "license": "000262",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0019EZ",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "1ST CARE",
            "identifier": "103267102",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCD TX HLTH STEPS",
            "identifier": "144326902",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC",
            "identifier": "0019EZ",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "144326901",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dalhart Family Medicine Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Dalhart Family Medicine Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dalhart, TX

Sources for this page

Verify at the official NPI Registry.