NPIMap

Organization Active NPI

Methodist Hospital Levelland

Doing business as Family Medicine of Levelland

  • Rural Health Clinic/Center
  • Levelland, TX
National Provider Identifier
1659360279
Registry record updated May 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
License
000307 Issued in TX
Legal business name
METHODIST HOSPITAL LEVELLAND
Doing business as
Family Medicine of Levelland
Practice address
116 John Dupree Dr
Levelland, TX 79336-6300
Phone
(806) 894-7900
Fax
(806) 894-7631
NPI assigned
Oct 17, 2005
Last updated
May 7, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
METHODIST HOSPITAL LEVELLANDAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 7, 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 5

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU
Obstetrics Physician 207VX0000X NU
Pediatrics Physician 208000000X NU
Surgery Physician 208600000X NU
Rural Health Clinic/Center 261QR1300X 000307 TX Primary

Addresses

Primary practice location

116 John Dupree Dr
Levelland, TX 79336-6300

Mailing address

PO Box 677044
Dallas, TX 75267-7044
Phone (806) 894-7900

Other identifiers 2

IdentifierTypeStateIssuer
063531001MedicaidTX
0003CVOtherTXBCBS

Other names 1

  • Family Medicine of Levelland Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100408000240 TX Part A Provider - Rural Health Clinic 8527041037 1 other NPI on this enrollment
Practice locations: Levelland, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1659360279. Details of each certification follow.

Rural health clinic certification: CCN 458605

Legal name
METHODIST HOSPITAL LEVELLAND
Doing business as
FAMILY MEDICINE OF LEVELLAND
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Feb 1, 1995
Last certification
Nov 15, 2016
Ownership / control type
1B
Organization structure
CorporationNon-profit
Incorporated
Aug 4, 1998 in TX
Enrollment address
116 John Dupree Dr
Levelland, TX 79336-6300
Related CCNs
450755

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
Tax ID family
Methodist Hosp Levellan4 organizations share this tax ID, including this one
Part of
Methodist Hosp Levellan

Other organizations with this tax ID 3

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

Locations

116 John Dupree Dr
Levelland, TX 79336
Phone (806) 894-1514

Ownership & related parties

All disclosed owners & managing parties 19

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
Newman Wheeler Individual Corporate OfficerCeo Feb 14, 2022
Corporate DirectorBoard Member Jan 1, 2023
Michael G Bailey Individual Corporate DirectorBoard Member Jan 1, 2023
Joel B White Individual Corporate DirectorBoard Member Oct 1, 2025
Rebecca Currington Individual Corporate DirectorBoard Member Jan 1, 2022
Providence Health & Services - Washington Organization, Renton, WA Corporation, Non-profit Operational/Managerial Control Aug 1, 2020
Lisa Guzman Individual Corporate DirectorBoard Member Feb 23, 2023
Covenant Health System Organization, Lubbock, TX Corporation, Non-profit 5% Or Greater Direct Ownership Interest Aug 13, 1988 100%
Cora Rivera Individual Corporate OfficerCfo Oct 31, 2023
Lubbock Methodist Hospital System Organization, Lubbock, TX Corporation, Non-profit Other Apr 1, 1999 43%
Deette Edens Individual Corporate DirectorBoard Member Jan 1, 2023
Crystal Gonzales Individual W-2 Managing EmployeeClinic Supervisor Jan 1, 2015
Johnathon Morin Individual W-2 Managing EmployeeClinic Manager Sep 30, 2019
Kenneth Shipley Individual Corporate DirectorBoard Member Jan 1, 2023
Donald Wayne Anderson Individual Corporate OfficerAssistant Secretary of Enrollments Sep 1, 2020
Gregory David Hoffman Individual Corporate OfficerCfo/Treasurer Jan 1, 2023
St. Joseph Health System Organization, Irvine, CA Corporation, Non-profit Other Jul 1, 1998 57%
Dyana Kerr Individual W-2 Managing EmployeeRegional Financial Executive Mar 1, 2023
Providence St. Joseph Health Organization, Renton, WA Corporation, Non-profit Other Jul 1, 2016

Owners & managing parties with NPI records 3

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

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": "1129507200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746576000000",
    "number": "1659360279",
    "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": "806-894-7900",
            "fax_number": "806-894-7631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 JOHN DUPREE DR",
            "city": "LEVELLAND",
            "state": "TX",
            "postal_code": "793366300",
            "telephone_number": "806-894-7900",
            "fax_number": "806-894-7631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METHODIST HOSPITAL LEVELLAND",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "METHODIST HOSPITAL LEVELLAND",
        "enumeration_date": "2005-10-17",
        "last_updated": "2025-05-07",
        "certification_date": "2025-05-07",
        "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": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207VX0000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "TX",
            "license": "000307",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "063531001",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0003CV",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Medicine of Levelland",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Family Medicine of Levelland",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Levelland, TX

Sources for this page

Verify at the official NPI Registry.