NPIMap

Organization Active NPI

Prime Healthcare Services Pampa LLC

  • Rural Health Clinic/Center
  • Pampa, TX
National Provider Identifier
1659993145
Registry record updated Jan 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
PRIME HEALTHCARE SERVICES PAMPA LLC
Practice address
3023 Perryton Pkwy
Pampa, TX 79065-2821
Phone
(806) 665-0801
NPI assigned
May 7, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2026

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

Authorized official

Name
Christopher Doan
Title
Managing Associate General Counsel
Phone
(310) 259-4706

Specialties & licenses 1

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

Addresses

Primary practice location

3023 Perryton Pkwy
Pampa, TX 79065-2821

Mailing address

One Medical Plaza
Pampa, TX 79065
Phone (806) 665-0801

Other names 1

  • Pampa Medical Group Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200702000590 TX Part A Provider - Rural Health Clinic 5092979716 Practice locations: Pampa, TX

Rural health clinic certification: CCN 673492

Legal name
PRIME HEALTHCARE SERVICES PAMPA LLC
Doing business as
PAMPA MEDICAL GROUP
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Dec 30, 2020
Last certification
Nov 29, 2023
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Mar 21, 2011 in DE
Enrollment address
3023 Perryton Pkwy
Pampa, TX 79065-2817
Related CCNs
451398

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

Other NPIs with the same Medicare PAC ID 3

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

National Provider Directory

National Provider Directory
Tax ID family
Prime Healthcare Services Pampa LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

3023 Perryton Pkwy
Pampa, TX 79065
Phone (806) 665-0801

Ownership & related parties

All disclosed owners & managing parties 6

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

NameRoleSinceShare
David M Hampton Individual Corporate DirectorBoard of Directors Member Jan 1, 2014 5%
Operational/Managerial ControlBoard of Directors Member Jan 1, 2014 5%
Rene P Grabato Individual Corporate DirectorBoard of Directors Member Jan 1, 2016 5%
Operational/Managerial ControlBoard of Directors Member Jan 1, 2016 5%
Prime Healthcare Services Pampa LLC Organization, Pampa, TX Corporation, Non-profit 5% Or Greater Direct Ownership Interest Jun 17, 2009 100%
Operational/Managerial Control Mar 30, 2014 100%
Christopher Doan Individual Corporate OfficerManaging Associate General Counsel Mar 30, 2014
Jenifer E Richards Individual W-2 Managing EmployeePractice Manager Mar 30, 2014 5%
Operational/Managerial ControlPractice Manager Mar 30, 2014 5%
Kevin D Sieck Individual Corporate DirectorBoard of Dicrectors Member Sep 1, 2018 5%
Operational/Managerial ControlBoard of Directors Member Sep 1, 2018 5%

Owners & managing parties with NPI records 5

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

NPI Registry JSON

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

{
    "created_epoch": "1588809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769040000000",
    "number": "1659993145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ONE MEDICAL PLAZA",
            "city": "PAMPA",
            "state": "TX",
            "postal_code": "79065",
            "telephone_number": "806-665-0801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3023 PERRYTON PKWY",
            "city": "PAMPA",
            "state": "TX",
            "postal_code": "790652821",
            "telephone_number": "806-665-0801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME HEALTHCARE SERVICES PAMPA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-07",
        "last_updated": "2026-01-22",
        "certification_date": "2026-01-22",
        "status": "A",
        "authorized_official_last_name": "DOAN",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "MANAGING ASSOCIATE GENERAL COUNSEL",
        "authorized_official_telephone_number": "310-259-4706"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pampa Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pampa, TX

Sources for this page

Verify at the official NPI Registry.