Methodist Hospital Levelland
Organization Active NPI Rural Health Clinic/Center · Levelland, TX
NPI 1508855313 · NPPES record last updated May 7, 2025
Key facts
- NPI
- 1508855313
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Health Clinic/Center 261QR1300X
- License
- 000307 (TX)
- Legal business name
- METHODIST HOSPITAL LEVELLAND
- Practice address
- 1804 College Ave
Levelland, TX 79336-6507 - Phone
- (806) 894-3141
- Fax
- (806) 894-7094
- NPI assigned
- Oct 14, 2005
- Organization subpart
- Yes
- Parent organization (as reported)
- METHODIST HOSPITAL LEVELLAND
Authorized official
- Name
- Donald W Anderson Jr.
- Title
- Assistant Secretary of Enrollments
- Phone
- (425) 358-9786
Owners & managing parties with NPI records 3
-
Deette Edens, MSN, APRN, FNP-C
Other NPIs with the same Medicare PAC ID 5
Corporate family (same tax ID) 3
Member of 1
Related certifications (CCN) 2
Facilities with the same owner 139
Practitioners 12
-
Amy Brooke Barrett, MSN, APRN, FNP-C
-
Amie Brogden, FNP
-
Allan Castillo Camacho, M.D.
-
Amy Charlene Land, APRN, FNP-C
-
Sabino Joshua Lopez, CRNA
-
Tommie Vidales, FNP
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 45D0507408 | Levelland Clinic | Certificate of waiver | Aug 31, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Rural health clinic certification: CCN 673988
- Legal name
- METHODIST HOSPITAL LEVELLAND
- Doing business as
- LEVELLAND CLINIC
- Certification status
- Active
- Provider type (POS)
- Rural health clinic
- Participating since
- Apr 9, 1992
- Last certification
- Jun 7, 2017
- Ownership / control type
- 2B
- Organization structure
- Corporation · Non-profit
- Incorporated
- Aug 4, 1998 in TX
- Enrollment address
- 1804 College Ave
Levelland, TX 79336-6507 - Related CCNs
- 450755
All disclosed owners & managing parties 19
| Name | Role | Since | Share |
|---|---|---|---|
| Kathleen Burrell |
Corporate Officer |
Mar 1, 2023 | |
| Newman Wheeler |
Corporate Officer |
Feb 14, 2022 | |
| Corporate Director |
Jan 1, 2023 | ||
| Michael G Bailey |
Corporate Director |
Jan 1, 2023 | |
| Joel B White |
Corporate Director |
Oct 1, 2025 | |
| Rebecca Currington |
Corporate Director |
Jan 1, 2022 | |
| Providence Health & Services - Washington |
Operational/Managerial Control | Sep 1, 2020 | |
| Lisa Guzman |
Corporate Director |
Feb 23, 2023 | |
| Covenant Health System |
Other | Aug 13, 1988 | |
| Cora Rivera |
Corporate Officer |
Oct 31, 2023 | |
| Lubbock Methodist Hospital System |
Other | Apr 1, 1999 | 43% |
| Deette Edens |
Corporate Director |
Jan 1, 2023 | |
| Crystal Gonzales |
W-2 Managing Employee |
Aug 13, 1988 | |
| Johnathon Morin |
W-2 Managing Employee |
Sep 30, 2019 | |
| Kenneth Shipley |
Corporate Director |
Jan 1, 2023 | |
| Donald Wayne Anderson |
Corporate Officer |
Sep 1, 2020 | |
| Gregory David Hoffman |
Corporate Officer |
Jan 1, 2023 | |
| St. Joseph Health System |
Other | Apr 1, 2020 | 57% |
| Dyana Kerr |
W-2 Managing Employee |
Mar 1, 2023 | |
| Providence St. Joseph Health |
Other | Jul 1, 2016 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100422000229 | TX | Part a Provider - Rural Health Clinic | 8527041037 | Practice locations: Levelland, TX |
National Provider Directory
- Tax ID family
- Family Medicine Clinic
- Part of
- Family Medicine Clinic
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | 000307 | TX | |
| Internal Medicine Physician |
207R00000X | 000307 | TX | |
| Obstetrics & Gynecology Physician |
207V00000X | 000307 | TX | |
| Surgery Physician |
208600000X | 000307 | TX | |
| Rural Health Clinic/Center | 261QR1300X | 000307 | TX | Yes |
Addresses
Primary practice location
1804 College Ave
Levelland, TX 79336-6507
Mailing address
PO Box 677044
Dallas, TX 75267-7044
Phone (806) 894-3141
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00K60V | Other | TX | BCBS |
| 107908102 | Other | TX | FIRSTCARE |
| 121337303 | Medicaid | TX |
Other names
- Levelland Clinic
Other providers in Levelland, TX
- Kelsey McMurry
- Methodist Hospital Levelland
- Methodist Hospital Levelland
- Methodist Hospital Levelland
- Methodist Hospital Levelland
- Methodist Hospital Levelland
- Methodist Hospital Levelland
- Elizabeth Jane Miller
- Mindful Path Healing, PLLC
- Norma Molinar
All providers in Levelland, TX · Rural Health Clinic/Center in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 7, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.