NPIMap

Organization Active NPI

Comanche County Medical Center Company

  • Rural Health Clinic/Center
  • Dublin, TX
National Provider Identifier
1215545561
Registry record updated Jul 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
COMANCHE COUNTY MEDICAL CENTER COMPANY
Practice address
305 N Patrick St
Dublin, TX 76446-1918
Phone
(254) 445-4900
Fax
(254) 879-4991
NPI assigned
Jul 22, 2020
Organization subpart
Yes
Parent organization
COMANCHE COUNTY MEDICAL CENTER COMPANYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 22, 2020

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

Authorized official

Name
Nikki Stark
Title
Director of Clinic Operations
Phone
(254) 879-4910

Specialties & licenses 1

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

Addresses

Primary practice location

305 N Patrick St
Dublin, TX 76446-1918

Mailing address

10201 Highway 16
Comanche, TX 76442-4462
Phone (254) 879-4910

Other names 1

  • Dublin Family Medicine Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201027000330 TX Part A Provider - Rural Health Clinic 4385552413 Practice locations: Dublin, TX

Rural health clinic certification: CCN 673499

Legal name
COMANCHE COUNTY MEDICAL CENTER COMPANY
Doing business as
DUBLIN FAMILY MEDICINE
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Feb 18, 2021
Last certification
Dec 14, 2023
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Jan 1, 2011 in TX
Enrollment address
305 N Patrick St
Dublin, TX 76446-1918
Related CCNs
451382

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

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
Comanche County Med Ctr

Ownership & related parties

All disclosed owners & managing parties 1

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

NameRoleSinceShare
Daniel Bonk Individual Corporate OfficerCeo Sep 21, 2025
W-2 Managing EmployeeCeo Sep 21, 2025

All facility ownership & control disclosures 2

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

FacilityTypeRoleSince
Comanche County Medical CenterComanche, TX, CCN 451382 Hospital 5% Or Greater Direct Ownership Interest Nov 1, 2011
Comanche County Medical Center CompanyRising Star, TX, CCN 678555 Rural health clinic Operational/Managerial Control Apr 1, 2021

Owned or controlled facilities with NPI records 2

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

NPI Registry JSON

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

{
    "created_epoch": "1595376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595376000000",
    "number": "1215545561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10201 HIGHWAY 16",
            "city": "COMANCHE",
            "state": "TX",
            "postal_code": "764424462",
            "telephone_number": "254-879-4910",
            "fax_number": "254-879-4991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 N PATRICK ST",
            "city": "DUBLIN",
            "state": "TX",
            "postal_code": "764461918",
            "telephone_number": "254-445-4900",
            "fax_number": "254-879-4991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMANCHE COUNTY MEDICAL CENTER COMPANY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COMANCHE COUNTY MEDICAL CENTER COMPANY",
        "enumeration_date": "2020-07-22",
        "last_updated": "2020-07-22",
        "certification_date": "2020-07-22",
        "status": "A",
        "authorized_official_last_name": "STARK",
        "authorized_official_first_name": "NIKKI",
        "authorized_official_title_or_position": "DIRECTOR OF CLINIC OPERATIONS",
        "authorized_official_telephone_number": "254-879-4910"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dublin Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dublin, TX

Sources for this page

Verify at the official NPI Registry.