Individual provider Active NPI

John Cline, NURSE PRACTITIONER

  • Acute Care Nurse Practitioner
  • Lubbock, TX
National Provider Identifier
1801806849
Registry record updated Jun 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
AP114689 Issued in TX
Practice address
602 Indiana Ave
Lubbock, TX 79415-3364
Phone
(806) 775-8607
Fax
(806) 775-8611
NPI assigned
Aug 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Personal Emergency Response Attendant 146D00000X RN625942 TX
Family Nurse Practitioner 363LF0000X AP114689 TX
Acute Care Nurse Practitioner 363LA2100X AP114689 TX Primary

Addresses

Primary practice location

602 Indiana Ave
Lubbock, TX 79415-3364

Mailing address

602 Indiana Ave
Lubbock, TX 79415-3364
Phone (806) 775-8607

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080819000951 TX Practitioner - Nurse Practitioner 9335214717 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lubbock County Hospital DistrictGroup PAC ID 4284617507, 65 clinicians

Practice addresses (Care Compare)

602 Indiana Ave
Lubbock, TX 79415-3364
Phone (806) 775-9700

Hospital & facility affiliations

  • University Medical Center Hospital, Lubbock, TX, CCN 450686

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN625942TXMDPersonal Emergency Response Attendant
AP114689TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lubbock County Hospital District CurrentSince Feb 15, 2016 Accepting new patients

Locations

11011 Slide Rd
Lubbock, TX 79424
Phone (806) 743-2584

602 Indiana Ave
Lubbock, TX 79415
Phone (806) 743-2898

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561680000000",
    "number": "1801806849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 INDIANA AVE",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794153364",
            "telephone_number": "806-775-8607",
            "fax_number": "806-775-8611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 INDIANA AVE",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794153364",
            "telephone_number": "806-775-8607",
            "fax_number": "806-775-8611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLINE",
        "first_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-09",
        "last_updated": "2019-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "146D00000X",
            "taxonomy_group": "",
            "desc": "Personal Emergency Response Attendant",
            "state": "TX",
            "license": "RN625942",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP114689",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "AP114689",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

Verify at the official NPI Registry.