Covenant High Plains Surgery Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

006930 Issued in TX

Legal business name

COVENANT HIGH PLAINS SURGERY CENTER, LLC

Doing business as

Covenant High Plains Surgery Center - Quaker Avenue

Practice address

2301 Quaker Ave
Lubbock, TX 79410-1874

Phone

(806) 725-8801

Fax

(806) 725-8820

NPI assigned

Apr 10, 2006

Last updated

Jun 7, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Shon Sanders

Title

Authorized Official

Phone

(610) 644-8900

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Covenant High Plains Surgery Center - Quaker Avenue Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

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

• Covenant High Plains Surgery Center, LLC

  dba Covenant High Plains Surgery Center - 22nd Street

  • Ambulatory Surgical Clinic/Center
  • Lubbock, TX
  • NPI 1871608216

  0840392726

  Same PAC ID

Listed as

Covenant High Plains Surgery CenterCCN 45C0001045

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Covenant High Plains Surgery Center2 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.

• Covenant High Plains Surgery Center, LLC

  dba Covenant High Plains Surgery Center - 22nd Street

  • Ambulatory Surgical Clinic/Center
  • Lubbock, TX
  • NPI 1871608216
  NPD tax ID

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Methodist Children's Hospital

  dba Covenant Home Infusion

  • Home Infusion Therapy Pharmacy
  • Lubbock, TX
  • NPI 1568451763

  Member Of

  NPD member

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

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686096000000",
    "number": "1932162195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 QUAKER AVE",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794101874",
            "telephone_number": "806-725-8801",
            "fax_number": "806-725-8820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 QUAKER AVE",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794101874",
            "telephone_number": "806-725-8801",
            "fax_number": "806-725-8820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COVENANT HIGH PLAINS SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-10",
        "last_updated": "2023-06-07",
        "certification_date": "2023-06-07",
        "status": "A",
        "authorized_official_last_name": "SANDERS",
        "authorized_official_first_name": "SHON",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "610-644-8900"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "TX",
            "license": "006930",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "085876301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Covenant High Plains Surgery Center - Quaker Avenue",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Covenant Health System (Covenant Ambulance Service)
• Covenant Health System
• Covenant Health System (Covenant Medical Center)
• Covenant Health System (Covenant Imaging Center)
• Covenant High Plains Surgery Center, LLC (Covenant High Plains Surgery Center - 22nd Street)
• Covenant Long-Term Care LLC (Covenant Specialty Hospital)
• Covenant Long-Term Care, LP (Covenant Specialty Hospital)
• Covenant Medical Center
• Covenant Medical Center (Covenant Health Pharmacy)
• Covenant Medical Center

• Ambulatory Surgical Clinic/Center in Lubbock, TX
• Providers in Lubbock, TX by specialty
• Ambulatory Surgical Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.