NPIMap

Organization Active NPI

Covenant Health System

  • Family Nurse Practitioner
  • Lubbock, TX
National Provider Identifier
1750410593
Registry record updated Nov 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
612528 Issued in TX
Legal business name
COVENANT HEALTH SYSTEM
Practice address
4101 22ND PL
Lubbock, TX 79410-1121
Phone
(806) 725-8000
Fax
(806) 723-6493
NPI assigned
Mar 5, 2007
Last updated
Nov 19, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2010

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

Authorized official

Name
Richard Park
Title
President and Ceo
Phone
(806) 725-6000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 612528 TX Primary

Addresses

Primary practice location

4101 22ND PL
Lubbock, TX 79410-1121

Mailing address

4101 22ND PL
Lubbock, TX 79410-1121
Phone (806) 725-8000

Other names 1

  • Joe Arrington Cancer Center Other name

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
45D2147040Joe Arrington Cancer Center, Lab 2ND Floor4101 22ND Place, Lubbock, TX 79410Certificate of waiverApr 10, 2028

National Provider Directory

National Provider Directory
Tax ID family
Gregory J Byrne MD11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

NPI Registry JSON

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1290124800000",
    "number": "1750410593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4101 22ND PL",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794101121",
            "telephone_number": "806-725-8000",
            "fax_number": "806-723-6493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4101 22ND PL",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794101121",
            "telephone_number": "806-725-8000",
            "fax_number": "806-723-6493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COVENANT HEALTH SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-05",
        "last_updated": "2010-11-19",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "806-725-6000"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "612528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Joe Arrington Cancer Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Lubbock, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.