Covenant Medical Group

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

COVENANT MEDICAL GROUP

Practice address

2215 Nashville Ave
Lubbock, TX 79410-1105

Phone

(806) 725-4800

Fax

(806) 723-6532

NPI assigned

May 23, 2006

Last updated

Sep 23, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kristen Kothmann

Title

Coo

Phone

(806) 725-4800

Specialties & licenses 11

Addresses

Other identifiers 5

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX, NM2 enrollments

Enrollment records 2

Other NPIs with the same Medicare PAC ID 1

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

• Covenant Medical Group

  dba Covenant Family Healthcare Center

  • Rural Health Clinic/Center
  • Abernathy, TX
  • NPI 1538412895

  6901889393

  Same PAC ID

Locations (25 of 76)

Practitioners 578

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.

• Cynthia Adame, FNP

  • Family Nurse Practitioner
  • Lubbock, TX
  • NPI 1730624099
  Medicare reassignment Care Compare group NPD
• Achankeng Afiadata, M.D.

  • Urology Physician
  • Lubbock, TX
  • NPI 1851786321
  Medicare reassignment Care Compare group NPD
• Khondoker Alam, M.D

  • Neurology Physician
  • Lubbock, TX
  • NPI 1992185201
  Medicare reassignment Care Compare group NPD
• Kyle S. Anderson, DO

  • Family Medicine Physician
  • Lubbock, TX
  • NPI 1942939079
  Medicare reassignment Care Compare group NPD
• Gabriel Axelrud, M.D.

  • Radiation Oncology Physician
  • Lubbock, TX
  • NPI 1376955435

  NM

  Medicare reassignment Care Compare group NPD
• Michael Gene Bailey, MD

  • Family Medicine Physician
  • Levelland, TX
  • NPI 1487642393
  Medicare reassignment Care Compare group NPD
• Katy Baker, ACNPC-AG

  • Acute Care Nurse Practitioner
  • Lubbock, TX
  • NPI 1639055015
  Medicare reassignment Care Compare group NPD
• Kyler W. Barkley, MD

  • Cardiovascular Disease Physician
  • Lubbock, TX
  • NPI 1144545781
  Medicare reassignment Care Compare group NPD
• Benjamin Batson, DO

  • Pulmonary Disease Physician
  • Lubbock, TX
  • NPI 1699296954
  Medicare reassignment Care Compare group NPD
• Chadwick Dale Beaver, ACNP

  • Acute Care Nurse Practitioner
  • Lubbock, TX
  • NPI 1194054239
  Medicare reassignment Care Compare group NPD
• Rachel Kimberly Bennings-Shearer

  • Family Nurse Practitioner
  • Lubbock, TX
  • NPI 1154291136
  Medicare reassignment Care Compare group NPD
• Jessica Ann Berryhill, LCSW LCDC

  • Clinical Social Worker
  • Lubbock, TX
  • NPI 1255113445
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600819200000",
    "number": "1376598904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2215 NASHVILLE AVE",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794101105",
            "telephone_number": "806-725-5844",
            "fax_number": "806-723-6532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2215 NASHVILLE AVE",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794101105",
            "telephone_number": "806-725-4800",
            "fax_number": "806-723-6532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COVENANT MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-23",
        "last_updated": "2020-09-23",
        "certification_date": "2020-09-23",
        "status": "A",
        "authorized_official_last_name": "KOTHMANN",
        "authorized_official_first_name": "KRISTEN",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "806-725-4800"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "141656201",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS TX",
            "identifier": "0038GH",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "A7086",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NM",
            "identifier": "NM007E61",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G1594",
            "state": "NM"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.covhs.org/open",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2215 Nashville Ave",
            "city": "Lubbock",
            "state": "TX",
            "country_code": "US",
            "postal_code": "794101105",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Covenant Long-Term Care LLC (Covenant Specialty Hospital)
• Covenant Long-Term Care, LP (Covenant Specialty Hospital)
• Covenant Medical Center
• Covenant Medical Center (Covenant Health Pharmacy)
• Covenant Medical Center
• Covenant Medical Group (Covenant Medical Group Urgent Care)
• Covenant Rehabilitation Hospital of Lubbock LLC (TrustPoint Rehabilitation Hospital of Lubbock)
• Covenant Rehabilitation Hospital of Lubbock LLC (TrustPoint Rehabilitation Hospital of Lubbock)
• Covenant Rehabilitation Hospital of Lubbock LLC (TrustPoint Rehabilitation Hospital of Lubbock)
• Covenant Rehabilitation Hospital of Lubbock LLC (TrustPoint Rehabilitation Hospital of Lubbock)

• Family Medicine Physician in Lubbock, TX
• Providers in Lubbock, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2020; 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.