NPIMap

Organization Active NPI

Family Healthcare of Bovina, PC

  • Rural Health Clinic/Center
  • Bovina, TX
National Provider Identifier
1881274850
Registry record updated Apr 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
FAMILY HEALTHCARE OF BOVINA, PC
Practice address
1100 Highway 86
Bovina, TX 79009-4518
Phone
(806) 238-1003
Fax
(806) 238-1023
NPI assigned
Apr 13, 2021
Last updated
Apr 13, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2021

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

Authorized official

Name
Kim McArthur, FNP-CNPI 1821320573
Title
Owner
Phone
(806) 238-1005

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

1100 Highway 86
Bovina, TX 79009-4518

Mailing address

1100 Highway 86
Bovina, TX 79009-4518
Phone (806) 238-1005

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20140925000056 TX Part B Supplier - Clinic/Group Practice 3375763360 Receives reassigned benefits from 1 practitioner
1 other NPI on this enrollment
Practice locations: Bovina, TX
O20210610002666 TX Part A Provider - Rural Health Clinic 3375763360 Practice locations: Bovina, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1881274850. Details of each certification follow.

Rural health clinic certification: CCN 673966

Legal name
FAMILY HEALTHCARE OF BOVINA PC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Dec 14, 2021
Last certification
Sep 24, 2024
Ownership / control type
1B
Organization structure
CorporationProprietary
Enrollment address
1100 Highway 86
Bovina, TX 79009-4518

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Family Health Care of Bovina PC Texas2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

1100 Highway 86
Bovina, TX 79009
Phone (806) 238-1005

Ownership & related parties

All disclosed owners & managing parties 2

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

NameRoleSinceShare
Kimberly B McArthur Individual Contracted Managing EmployeeOwner/FNP-C Sep 5, 2012 100%
5% Or Greater Direct Ownership InterestOwner/FNP-C Sep 5, 2012 100%
Krystal Reza Individual Corporate OfficerCmaa Feb 1, 2018

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1618272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618272000000",
    "number": "1881274850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 HIGHWAY 86",
            "city": "BOVINA",
            "state": "TX",
            "postal_code": "790094518",
            "telephone_number": "806-238-1005",
            "fax_number": "806-238-1023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 HIGHWAY 86",
            "city": "BOVINA",
            "state": "TX",
            "postal_code": "790094518",
            "telephone_number": "806-238-1003",
            "fax_number": "806-238-1023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY HEALTHCARE OF BOVINA, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-13",
        "last_updated": "2021-04-13",
        "certification_date": "2021-04-13",
        "status": "A",
        "authorized_official_last_name": "MCARTHUR",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "806-238-1005",
        "authorized_official_credential": "FNP-C"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bovina, TX

Sources for this page

Verify at the official NPI Registry.