NPIMap

Individual provider Active NPI

Anthony Betteridge, MD

  • Family Medicine Physician
  • Dyess AFB, TX
National Provider Identifier
1902489834
Registry record updated Aug 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
T9057 Issued in TX
Practice address
697 Louisiana Rd
Dyess AFB, TX 79607-1141
Phone
(325) 696-4677
Fax
(325) 696-5114
NPI assigned
Apr 29, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X T9057 TX
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X T9057 TX Primary

Addresses

Primary practice location

697 Louisiana Rd
Dyess AFB, TX 79607-1141

Mailing address

3601 4TH Street Mail Stop 9901
Lubbock, TX 79430
Phone (806) 743-2757

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230220001597 TX Practitioner - Family Practice 4284006289 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Texas Tech University Health Science Center School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lynn County Hospital DistrictGroup PAC ID 9739149295, shared by 6 NPIs, 16 clinicians
Concord Medical Group of Texas PLLCGroup PAC ID 7810117223, 319 clinicians

Practice addresses (Care Compare)

2600 Lockwood St
Tahoka, TX 79373-4118
Phone 8069984533320

304 S Daugherty Ave
Eastland, TX 76448-2609
Phone (254) 629-2601

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
T9057TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lynn County Hospital District Family Medicine Current Accepting new patients
Concord Medical Group of Texas PLLC CurrentSince Jun 14, 2024 Accepting new patients
Lynn County Hospital District Family Medicine CurrentSince Sep 22, 2025 Accepting new patients
Lynn County Hospital District CurrentSince Jan 1, 2023 Accepting new patients
Exceptional Physicians Group Lubbock Hospital PLLC CurrentSince Mar 13, 2024 Accepting new patients
Lynn County Hospital District Family Medicine CurrentSince Jan 1, 2023 Accepting new patients
Lynn County Hospital District Family Medicine Past Accepting new patients
Exceptional Health Care Lubbock LLC PastSince Nov 19, 2023 Accepting new patients
Lynnwood Assisted Living Past Accepting new patients
Texas Tech University Health Sciences Center Lubbock PastSince May 1, 2021 Accepting new patients
Lynn County Hospital District Family Medicine Past Accepting new patients
Lynn County Hospital District Past Accepting new patients

Locations

200 S Geneva St
Breckenridge, TX 76424
Phone (254) 559-2241

3514 Cedar Springs Rd
Dallas, TX 75219
Phone (281) 415-6687

304 S Daugherty Ave
Eastland, TX 76448
Phone (254) 629-2601

6401 Spur 327
Lubbock, TX 79424
Phone (436) 341-7800

1104 N Avenue S
Post, TX 79356
Phone (806) 495-2853

2600 Lockwood St
Tahoka, TX 79373
Phone (806) 998-4533

2600 Lockwood St
Ste C
Tahoka, TX 79373
Phone 8069984533322

Organizations & group practices 12

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 3

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": "1619654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723852800000",
    "number": "1902489834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3601 4TH STREET MAIL STOP 9901",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "79430",
            "telephone_number": "806-743-2757",
            "fax_number": "806-743-1180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "697 LOUISIANA RD",
            "city": "DYESS AFB",
            "state": "TX",
            "postal_code": "796071141",
            "telephone_number": "325-696-4677",
            "fax_number": "325-696-5114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BETTERIDGE",
        "first_name": "ANTHONY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-29",
        "last_updated": "2024-08-17",
        "certification_date": "2024-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "TX",
            "license": "T9057",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "T9057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dyess AFB, TX

Sources for this page

Verify at the official NPI Registry.