LUBBOCK HERITAGE HOSPITAL, LLC (NPI# 1154767580) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154767580 |
| Entity Type | Organization |
| Organization Name | LUBBOCK HERITAGE HOSPITAL, LLC |
| Other Organization Name | GRACE MEDICAL CENTER |
| Practice Address |
2412 50th St Lubbock TX 79412-2504 |
| Practice Telephone | 8067884000 |
| Practice Fax Number | 8067884278 |
| Mailing Telephone | 8067884000 |
| Mailing Fax Number | 8067884278 |
| Enumeration Date | 2013-05-13 |
| Last Update Date | 2013-05-13 |
| Authorized Official Name | MRS. DANA RAINS (CEO) |
| Authorized Official Telephone | 8067884000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 282N00000X | General Acute Care Hospital | 008730 | TX | Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 281514401 | 05 |
| Other Name | Type Code |
|---|---|
| Grace Medical Center | Doing Business As Name - Organization |
| Street Address |
2412 50TH ST |
| City | LUBBOCK |
| State | TX |
| Zip Code | 79412-2504 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124023718 | Melissa Henry | Family Medicine | 2412 50th St, Lubbock, TX 79412 | 2005-06-20 |
| 1740846955 | Clarissa Syvonne Elizondo | Physician Assistant | 2412 50th St, Lubbock, TX 79412-2504 | 2019-05-13 |
| 1003370909 | Kayleigh Mccarrell | Nurse Anesthetist, Certified Registered | 2412 50th St, Lubbock, TX 79412-2504 | 2019-01-24 |
| 1558852913 | Mason Gibson | Anesthesiologist Assistant | 2412 50th St, Lubbock, TX 79412 | 2018-05-22 |
| 1770074288 | Addie L Powers | Nurse Anesthetist, Certified Registered | 2412 50th St, Lubbock, TX 79412-2504 | 2018-05-21 |
| 1760993844 | Lennon Ndi | Nurse Practitioner | 2412 50th St, Lubbock, TX 79412-2504 | 2017-10-17 |
| 1639607062 | Paula Galloway | Anesthesiologist Assistant | 2412 50th St, Lubbock, TX 79412-2504 | 2017-05-30 |
| 1386181949 | Andrea Griego | Nurse Anesthetist, Certified Registered | 2412 50th St, Lubbock, TX 79412-2504 | 2017-01-20 |
| 1902342231 | Norah Bate | Nurse Practitioner | 2412 50th St, Lubbock, TX 79412-2504 | 2017-01-10 |
| 1659754695 | Ramya Krishna Undamatla | Internal Medicine | 2412 50th St, Lubbock, TX 79412-2504 | 2015-07-08 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801420864 | The Kidney Care Center, LLC | Clinic/Center | 3702 Interstate 27, Lubbock, TX 79412 | 2020-02-28 |
| 1639531254 | Lori Ann Boyd | Dietitian, Registered | 2412 50 Th Street, Lubbock, TX 79412 | 2016-03-23 |
| 1073989083 | Jesse Garcia | Social Worker | 6104 Ave. Q South Drive, Lubbock, TX 79412 | 2015-08-12 |
| 1316294408 | Ronald Caporale | Physician Assistant | 1701 50th Street, Lubbock, TX 79412 | 2012-08-08 |
| 1508152901 | Lilian Francisca Hayes | Counselor | 2345 50th St., Lubbock, TX 79412 | 2011-06-23 |
| 1861787285 | Sarah Delacruz | Counselor | 2345 50th Street, Lubbock, TX 79412 | 2011-06-14 |
| 1407189558 | David G Smith | Counselor | 2345 50th Managed Care Center, Lubbock, TX 79412 | 2009-09-08 |
| 1427261205 | Barbara J Trotter | Dietitian, Registered | 5022 Ave Q, Covenant Ctr for Outpatient Diabetes Education Lubbock, Lubbock, TX 79412 | 2007-05-08 |
| 1447471057 | Elmer Artemus Addington IIi | Chiropractor | 3410 Avenue Q, Lubbock, TX 79412 | 2007-05-01 |
| 1083779805 | Shaun Hamlett Keel PC | Psychologist | 2402 52nd St., Suite 6, Lubbock, TX 79412 | 2006-12-22 |
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| Taxonomy Code | 282N00000X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| An acute general hospital is an institution whose primary function is to provide inpatient diagnostic and therapeutic services for a variety of medical conditions, both surgical and non-surgical, to a wide population group. The hospital treats patients in an acute phase of illness or injury, characterized by a single episode or a fairly short duration, from which the patient returns to his or her normal or previous level of activity. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649401050 | Quaker Medical Lp | General Acute Care Hospital | 4302 Princeton St Unit B, Lubbock, TX 79415-1307 | 2009-08-03 |
| 1184888695 | Texas Tech University Health Sciences | General Acute Care Hospital | 4812 100th St, Lubbock, TX 79424-5702 | 2008-07-14 |
| 1013941780 | Covenant Long-term Care, Lp | General Acute Care Hospital | 3815 20th Street, Lubbock, TX 79410-1203 | 2006-07-10 |
| 1922001775 | Lubbock Heart Hospital, LLC | General Acute Care Hospital | 4810 North Loop 289, Lubbock, TX 79416-3025 | 2005-05-24 |
| 1518348747 | Covenant Rehabilitation Hospital of Lubbock LLC | General Acute Care Hospital | 4302 Princeton St, Lubbock, TX 79415-1304 | 2015-06-12 |
| 1497159966 | Tracy Lynn Newton | General Acute Care Hospital | 602 Indiana Ave, Lubbock, TX 79415-3364 | 2014-10-13 |
| 1598900946 | Lubbock County Hospital District | General Acute Care Hospital | 602 Indiana Ave, Lubbock, TX 79415-3364 | 2008-12-12 |
| 1225289499 | Lubbock Heritage Hospital, LLC. | General Acute Care Hospital | 2412 50th St, Lubbock, TX 79412-2504 | 2008-10-07 |
| 1245402866 | North Quaker Hospital, Lp | General Acute Care Hospital | 4302 Princeton Street, Lubbock, TX 79415-1304 | 2008-03-25 |
| 1063557544 | Covenant Health System | General Acute Care Hospital | 3615 19th St, Lubbock, TX 79410-1203 | 2007-02-21 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.