Active NPI
Cheryl Ann Kite, ANP
- Nurse Practitioner
- Texarkana, TX
National Provider Identifier
1164420501
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 691578
- Practice address
- 5002 Cowhorn Creek Rd
Texarkana, TX 75503 - Phone
- (903) 614-3000
- Fax
- (903) 614-3525
- NPI assigned
- Jul 11, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | AO1521 | AR | |
| Nurse Practitioner | 363L00000X | 691578 | TX | Primary |
Addresses
Primary practice location
5002 Cowhorn Creek Rd
Texarkana, TX 75503
Mailing address
5002 Cowhorn Creek Rd
Texarkana, TX 75503-9766
Phone (903) 614-3000
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 143581758 | Other | AK | MEDICAID |
| 144772402 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180628002930 | TX | Practitioner - Nurse Practitioner | 6800868720 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AO1521 | AR | MD | Nurse Practitioner |
| 691578 | TX | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Collom & Carney Clinic Association | Current | Accepting new patients | |
| Collom and Carney Clinic Association | Current | Accepting new patients | |
| Collom & Carney Clinic Association | Current | Accepting new patients | |
| Collom & Carney Clinic Association | Current | Accepting new patients | |
| Collom & Carney Clinic Association | Current | Accepting new patients | |
| Collom & Carney Clinic Association | Current | Accepting new patients | |
| Collom and Carney Clinic Association | Past | Accepting new patients | |
| Collom and Carney Clinic Association | Past | Accepting new patients |
Locations
1000 Pine St
Texarkana, TX 75501
Phone (903) 798-7365
5002 Cowhorn Creek Rd
Texarkana, TX 75503
Phone (903) 614-3008
2931 Richmond Rd
Texarkana, TX 75503
Phone (903) 614-3200
Interoperability endpoints
- cheryl.kite.p1@direct.collom-carney.nextgenshare.com
Organizations & group practices 8
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.
-
- Cardiovascular Disease Physician
- Texarkana, TX
- NPI 1013252279
-
- Clinical Medical Laboratory
- Texarkana, TX
- NPI 1164405296
-
- Nephrology Physician
- Texarkana, TX
- NPI 1265414635
-
- Pain Medicine (Anesthesiology) Physician
- Texarkana, TX
- NPI 1962829747
-
- Pediatrics Physician
- Texarkana, TX
- NPI 1588646301
-
- Neurology Physician
- Texarkana, TX
- NPI 1215918693
-
- Clinic/Center
- Texarkana, TX
- NPI 1871575514
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121040000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1528675200000",
"number": "1164420501",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5002 COWHORN CREEK RD",
"city": "TEXARKANA",
"state": "TX",
"postal_code": "755039766",
"telephone_number": "903-614-3000",
"fax_number": "903-614-3525"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5002 COWHORN CREEK RD",
"city": "TEXARKANA",
"state": "TX",
"postal_code": "75503",
"telephone_number": "903-614-3000",
"fax_number": "903-614-3525"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KITE",
"first_name": "CHERYL",
"middle_name": "ANN",
"credential": "ANP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-07-11",
"last_updated": "2018-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "AR",
"license": "AO1521",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "TX",
"license": "691578",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAID",
"identifier": "143581758",
"state": "AK"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "144772402",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Texarkana, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.