Collom & Carney Clinic Association

Primary specialty

End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X

Legal business name

COLLOM & CARNEY CLINIC ASSOCIATION

Doing business as

Hempstead County Dialysis Unit

Practice address

1803 S Laurel St
Hope, AR 71801-8219

Phone

(903) 614-3600

Fax

(903) 792-0951

NPI assigned

Nov 16, 2005

Last updated

Mar 23, 2010By 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

Ms. Pat Roberts

Title

Administrator

Phone

(903) 614-3601

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Hempstead County Dialysis Unit Doing business as

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

{
    "created_epoch": "1132099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1269302400000",
    "number": "1609858679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1803 S LAUREL ST",
            "city": "HOPE",
            "state": "AR",
            "postal_code": "718018219",
            "telephone_number": "903-614-3600",
            "fax_number": "903-792-0951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1803 S LAUREL ST",
            "city": "HOPE",
            "state": "AR",
            "postal_code": "718018219",
            "telephone_number": "903-614-3600",
            "fax_number": "903-792-0951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLLOM & CARNEY CLINIC ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-16",
        "last_updated": "2010-03-23",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "PAT",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "903-614-3601",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "145423134",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hempstead County Dialysis Unit",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• William C Coffee, O.D.
• William Trevor Coffee, DDS
• Vickie Ann Cole
• Jaycie E Collier, LAC
• Sarah Collins
• Erica Monique Conway, APRN
• Sarah Ann Cook, APRN
• Chelsea Cooley
• Andrea Cooper
• Vaster Leshawn Cooper II

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Hope, AR
• Providers in Hope, AR by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.