COLLOM AND CARNEY CLINIC ASSOCIATION (NPI# 1619959244) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619959244 |
| Entity Type | Organization |
| Organization Name | COLLOM AND CARNEY CLINIC ASSOCIATION |
| Other Organization Name | COLLOM AND CARNEY CLINIC INTERNAL MEDICINE |
| Practice Address |
5002 Cowhorn Creek Rd Texarkana TX 75503 |
| Practice Telephone | 9036143000 |
| Practice Fax Number | 9036143525 |
| Mailing Telephone | 9036143000 |
| Mailing Fax Number | 9036143525 |
| Enumeration Date | 2005-11-18 |
| Last Update Date | 2019-10-01 |
| Authorized Official Name | MARY E DWIGHT (CHIEF OPERATING OFFICER) |
| Authorized Official Telephone | 9036143282 |
| Authorized Official Credential | CCS-P, MHA, CMPE |
| Is Organization Subpart | Y |
| Parent Organization Name | COLLOM AND CARNEY CLINIC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| RAILROAD MEDICARE | CU0435 | 01 | |
| AR | 107491002 | 05 | |
| TX | 082234801 | 05 |
| Other Name | Type Code |
|---|---|
| Collom and Carney Clinic Internal Medicine | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407273287 | Collom and Carney Clinic Association | Neurological Surgery | 5002 Cowhorn Creek Rd, Texarkana, TX 75503-9766 | 2014-03-18 |
| 1316364193 | Collom and Carney Clinic Association | Radiology | 511 W 11th St, Texarkana, TX 75501-4300 | 2014-03-18 |
| 1265414635 | Collom and Carney Clinic Association | Internal Medicine | 5002 Cowhorn Creek Rd, Texarkana, TX 75503 | 2005-11-18 |
| 1447232814 | Collom and Carney Clinic Association | Clinic/Center | 5002 Cowhorn Creek Rd, Texarkana, TX 75503-9766 | 2005-11-18 |
| 1285616805 | Collom and Carney Clinic Association | Family Medicine | 5002 Cowhorn Creek Rd, Texarkana, TX 75503 | 2005-11-18 |
| 1376525832 | Collom and Carney Clinic Association | Otolaryngology | 5002 Cowhorn Creek Rd, Texarkana, TX 75503-9766 | 2005-11-18 |
| 1952383770 | Collom and Carney Clinic Association | Physical Medicine & Rehabilitation | 5002 Cowhorn Creek Rd, Texarkana, TX 75503 | 2005-11-17 |
| 1588646301 | Collom and Carney Clinic Association | Pediatrics | 5002 Cowhorn Creek Rd, Texarkana, TX 75503-9766 | 2005-11-17 |
| 1285616003 | Collom and Carney Clinic Association | Internal Medicine | 5002 Cowhorn Creek Rd, Texarkana, TX 75503 | 2005-11-17 |
| 1083696801 | Collom and Carney Clinic Association | Internal Medicine | 5002 Cowhorn Creek Rd, Texarkana, TX 75503-9766 | 2005-11-17 |
| Street Address |
5002 COWHORN CREEK RD |
| City | TEXARKANA |
| State | TX |
| Zip Code | 75503 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447255229 | Jeffrey David Decaprio | Surgery | 5002 Cowhorn Creek Rd, Texarkana, TX 75503-9766 | 2005-06-17 |
| 1225681604 | Lauren N. Hadaway | Nurse Practitioner | 5002 Cowhorn Creek Rd, Texarkana, TX 75503-9766 | 2019-07-24 |
| 1144872839 | Brandi M. Martin | Nurse Practitioner | 5002 Cowhorn Creek Rd, Texarkana, TX 75503-9766 | 2019-07-12 |
| 1093292104 | Heidi R Smith | Nurse Practitioner | 5002 Cowhorn Creek Rd, Texarkana, TX 75503-9766 | 2018-07-20 |
| 1194215814 | Angela L Bowen | Nurse Practitioner | 5002 Cowhorn Creek Rd, Texarkana, TX 75503-9766 | 2018-05-17 |
| 1689174955 | Cody C Ray | Nurse Practitioner | 5002 Cowhorn Creek Rd, Texarkana, TX 75503-9766 | 2018-02-13 |
| 1699282087 | Melissa Ann Lamon | Registered Nurse | 5002 Cowhorn Creek Rd, Texarkana, TX 75503 | 2018-01-07 |
| 1013443589 | Laura L Jackson | Nurse Practitioner | 5002 Cowhorn Creek Rd, Texarkana, TX 75503-9766 | 2017-05-03 |
| 1316478852 | Schamma Salomon | Internal Medicine | 5002 Cowhorn Creek Rd, Texarkana, TX 75503-9766 | 2017-03-26 |
| 1346781325 | Melissa Elizabeth Redfearn | Nurse Practitioner | 5002 Cowhorn Creek Rd, Texarkana, TX 75503-9766 | 2017-03-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770049397 | Jeffery Nash | Nurse Practitioner | #4 Valley View Circle, Texarkana, TX 75503 | 2019-02-19 |
| 1821583501 | Brandy D Acker | Psychologist | 3615 Richmond Rd, Texarkana, TX 75503 | 2018-06-26 |
| 1366935066 | Samantha Lee Harris | Nurse Practitioner | 4116 Mcknight Rd, Texarkana, TX 75503 | 2018-06-07 |
| 1811416910 | Heather Alison Gerber | Nurse Practitioner | 5903 Brenda Street, Texarkana, TX 75503 | 2017-09-11 |
| 1952838682 | John Kyle Abney | Counselor | 4134 Mcknight Rd, Texarkana, TX 75503 | 2017-05-12 |
| 1699151514 | Piney Woods Er IIi LLC | Clinic/Center | 4102 Gibson Lane, Texarkana, TX 75503 | 2015-08-03 |
| 1609282433 | Colby Rebecca Pair | Physician Assistant | 2604 St. Michael Dr., Suite 310, Texarkana, TX 75503 | 2014-07-01 |
| 1265842496 | Healthcare Express, LLP | Clinic/Center | 3513 Richmond Rd, Texarkana, TX 75503 | 2014-04-28 |
| 1134540628 | Eagle Dental Center of Texarkana Pllc | Dentist | 4009 Moores Ln, Texarkana, TX 75503 | 2013-12-30 |
| 1326481664 | Juancarlo S. Pascual | Family Medicine | 604 St. Michael Dr, Suite 340, Texarkana, TX 75503 | 2013-04-16 |
| Find all providers in zip 75503 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851699425 | Fred Atkinson Hutcheson Jr. | Internal Medicine | 3803 Colorado St, Texarkana, TX 75503-2812 | 2011-03-07 |
| 1376796037 | James Bernard Weedman | Internal Medicine | 1600 Arkansas Blvd Ste 100, Texarkana, AR 71854-1681 | 2008-10-28 |
| 1568636413 | Elie J Toubia | Internal Medicine | 1002 Texas Blvd Ste 201, Texarkana, TX 75501-5133 | 2008-04-22 |
| 1750394441 | Beverly J Greer-simpson | Internal Medicine | 910 Realtor Avenue, Veterans Outpatient Clinic of Texarkana, Texarkana, AR 71854 | 2006-08-14 |
| 1306888243 | Texarkana Internal Medicine Association Pa | Internal Medicine | 4082 Summerhill Sq, Texarkana, TX 75503-2730 | 2006-06-12 |
| 1841245883 | Jack R Childress | Internal Medicine | 2602 Saint Michael Dr Ste 205, Texarkana, TX 75503-2378 | 2006-05-24 |
| 1033187299 | Charles Chibundu Mbonu | Internal Medicine | 2604 St. Michael Drive, Suite 310, Texarkana, TX 75503 | 2006-03-14 |
| 1093796534 | Nathan J Wright | Internal Medicine | 2014 Galleria Oaks Dr, Texarkana, TX 75503-4620 | 2005-11-10 |
| 1851385793 | Donald Stratton Douglas | Internal Medicine | 3510 Richmond Rd, Suite C, Texarkana, TX 75503-0705 | 2005-09-07 |
| 1063417822 | Thomas Alston | Internal Medicine | 1400 College Dr, Ste 202, Texarkana, TX 75503-3575 | 2005-06-17 |
| Find all providers in TEXARKANA | ||||
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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.