NPIMap

Organization Active NPI

Collin County Adult Clinic

  • Primary Care Clinic/Center
  • Plano, TX
National Provider Identifier
1194090084
Registry record updated Jul 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
COLLIN COUNTY ADULT CLINIC
Practice address
2520 K Avenue, Suite 100
Plano, TX 75074
Phone
(972) 423-4941
Fax
(972) 423-2020
NPI assigned
Mar 12, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2015

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

Authorized official

Name
Mr. Jordan Daniel Robinson, J.D.,MHA
Title
Executive Director
Phone
(972) 423-4941

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

2520 K Avenue, Suite 100
Plano, TX 75074

Mailing address

2520 K Avenue, Suite 100
Plano, TX 75074
Phone (972) 423-4941

Other names 1

  • Collin County Community Health Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Federally qualified health center certification: CCN 741892

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
COLLIN COUNTY ADULT CLINIC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
May 22, 2015
Last certification
May 22, 2015
Ownership / control type
For profit – corporation
Facility address
2520 K Avenue, Suite 100
Plano, TX 75074

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1331510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437436800000",
    "number": "1194090084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2520 K AVENUE, SUITE 100",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "75074",
            "telephone_number": "972-423-4941",
            "fax_number": "972-423-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2520 K AVENUE, SUITE 100",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "75074",
            "telephone_number": "972-423-4941",
            "fax_number": "972-423-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLLIN COUNTY ADULT CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-12",
        "last_updated": "2015-07-21",
        "status": "A",
        "authorized_official_last_name": "ROBINSON",
        "authorized_official_first_name": "JORDAN",
        "authorized_official_middle_name": "DANIEL",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "972-423-4941",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "J.D.,MHA"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Collin County Community Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Plano, TX

Sources for this page

Verify at the official NPI Registry.