NPIMap

Organization Active NPI

Methodist Hospital Plainview Texas

Doing business as Covenant Healthcare Center Plainview

  • Rural Health Clinic/Center
  • Plainview, TX
National Provider Identifier
1417965286
Registry record updated Sep 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
METHODIST HOSPITAL PLAINVIEW TEXAS
Doing business as
Covenant Healthcare Center Plainview
Practice address
2222 W 24TH St
Plainview, TX 79072-1802
Phone
(806) 291-5100
Fax
(806) 291-0069
NPI assigned
Aug 4, 2006
Last updated
Sep 15, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
METHODIST HOSPITAL PLAINVIEW TEXASAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 15, 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
Rural Health Clinic/Center 261QR1300X NU Primary

Addresses

Primary practice location

2222 W 24TH St
Plainview, TX 79072-1802

Mailing address

PO Box 677044
Dallas, TX 75267-7044
Phone (806) 291-5100

Other identifiers 1

IdentifierTypeStateIssuer
121079103MedicaidTX

Other names 1

  • Covenant Healthcare Center Plainview Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100602001011 TX Part A Provider - Rural Health Clinic 0749179521 Practice locations: Plainview, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1417965286. Details of each certification follow.

Rural health clinic certification: CCN 673992

Legal name
METHODIST HOSPITAL PLAINVIEW TEXAS
Doing business as
COVENANT HEALTHCARE CENTER PLAINVIEW
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
May 11, 1992
Last certification
Jan 15, 2019
Ownership / control type
1B
Organization structure
CorporationNon-profit
Incorporated
Mar 13, 1992 in TX
Enrollment address
2222 W 24TH St
Covenant Healthcare Center Plainview
Plainview, TX 79072-1802
Related CCNs
450539

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

Other NPIs with the same Medicare PAC ID 6

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
45D0874483Covenant Healthcare Center Plainview2222 West 24TH St, Plainview, TX 79072Certificate of waiverSep 30, 2027

National Provider Directory

National Provider Directory
Tax ID family
Weidenbach Family Pract8 organizations share this tax ID, including this one
Part of
Weidenbach Family Pract

Other organizations with this tax ID 7

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

Member of 1

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

Locations

2222 W 24th St
Ste A
Plainview, TX 79072

Ownership & related parties

All disclosed owners & managing parties 22

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

NameRoleSinceShare
Kathleen Burrell Individual Corporate OfficerCorporate Secretary Mar 1, 2023
Mark Bacher Individual Corporate DirectorBoard Member Jan 1, 2024
Randall Kaufman Individual Corporate DirectorBoard Member Jan 1, 2022
Riley True Individual Corporate DirectorBoard Member Jan 1, 2021
Kimberlee Bentley Individual Corporate DirectorBoard Member Jan 1, 2024
John Tye Individual Corporate DirectorBoard Member Jan 1, 2022
Joshua W Rollins Individual Corporate DirectorBoard Member Jan 1, 2020
Norma Galvan Individual Corporate DirectorBoard Member Jan 1, 2024
Christopher Williams Individual Corporate DirectorBoard Member Jan 1, 2022
Dennis Dipprey Individual Corporate DirectorBoard Member Jan 1, 2022
Providence Health & Services - Washington Organization, Renton, WA Corporation, Non-profit Operational/Managerial Control Jan 1, 2019
Covenant Health System Organization, Lubbock, TX Corporation, Non-profit 5% Or Greater Direct Ownership Interest Apr 1, 1999
Cora Rivera Individual Corporate OfficerCfo Oct 31, 2023
Lubbock Methodist Hospital System Organization, Lubbock, TX Corporation, Non-profit Other Apr 1, 1999 43%
Anthony Longoria Individual Corporate DirectorBoard Member Jan 1, 2025
Cassie Dale Mogg Individual Corporate OfficerCeo Jan 1, 2021
Corporate DirectorBoard Member Jan 1, 2025
Donald Wayne Anderson Individual Corporate OfficerAssistant Secretary of Enrollmen Nov 1, 2020
Gregory David Hoffman Individual Corporate OfficerCfo/Treasurer Jan 1, 2023
St. Joseph Health System Organization, Irvine, CA Corporation, Non-profit, Chain home office Other May 11, 1992 57%
Dyana Kerr Individual W-2 Managing EmployeeRegional Financial Executive Mar 1, 2023
Sheron Collins Individual Corporate DirectorBoard Member Feb 22, 2022
Providence St. Joseph Health Organization, Renton, WA Corporation, Non-profit Other Jul 1, 2016

Owners & managing parties with NPI records 2

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

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Covenant West Texas Family Medicine of Hale CenterHale Center, TX, CCN 678553 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Mar 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.

Facilities with the same owner 140

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

View all 140

NPI Registry JSON

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757894400000",
    "number": "1417965286",
    "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": "806-291-5100",
            "fax_number": "806-291-0069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 W 24TH ST",
            "city": "PLAINVIEW",
            "state": "TX",
            "postal_code": "790721802",
            "telephone_number": "806-291-5100",
            "fax_number": "806-291-0069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METHODIST HOSPITAL PLAINVIEW TEXAS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "METHODIST HOSPITAL PLAINVIEW TEXAS",
        "enumeration_date": "2006-08-04",
        "last_updated": "2025-09-15",
        "certification_date": "2025-09-15",
        "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": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "121079103",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Covenant Healthcare Center Plainview",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Covenant Healthcare Center Plainview",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Plainview, TX

Sources for this page

Verify at the official NPI Registry.