NPIMap

Organization Active NPI

Collom & Carney Clinic Association

  • Urology Physician
  • Texarkana, TX
National Provider Identifier
1700868528
Registry record updated Dec 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
COLLOM & CARNEY CLINIC ASSOCIATION
Practice address
1902 Moores LN
Texarkana, TX 75503-4610
Phone
(903) 792-7515
NPI assigned
Nov 17, 2005
Organization subpart
Yes
Parent organization
COLLOM & CARNEY CLINIC ASSOCIATIONAs reported in NPPES

Authorized official

NPPES NPI Registry
Name
Dana Robyn Morton
Title
Director Contracting Credentialing
Phone
(903) 614-3283

Other NPIs on the same Medicare enrollment 20

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 20

Practitioners 4

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031226000046 TX Part B Supplier - Clinic/Group Practice 1355249541 Receives reassigned benefits from 48 practitioners
20 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Texarkana, TX; Atlanta, TX; New Boston, TX

National Provider Directory

National Provider Directory
Part of
Nashville Dialysis Unit

Locations

1902 Moores Ln
Texarkana, TX 75503
Phone (903) 614-3850

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ZP0102X
Urology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208800000X Primary

Addresses

NPPES NPI Registry

Primary practice location

1902 Moores LN
Texarkana, TX 75503-4610

Mailing address

5002 Cowhorn Creek Rd
Texarkana, TX 75503-9766
Phone (903) 614-3000

Other identifiers 2

NPPES NPI Registry
IdentifierTypeStateIssuer
CU0435OtherRAILROAD MEDICARE
082240501MedicaidTX

Other names 1

NPPES NPI Registry
  • Collom and Carney Clinic Urology Other name

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 19, 2025.

{
    "created_epoch": "1132185600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1766102400000",
    "number": "1700868528",
    "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": "1902 MOORES LN",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755034610",
            "telephone_number": "903-792-7515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLLOM & CARNEY CLINIC ASSOCIATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COLLOM & CARNEY CLINIC ASSOCIATION",
        "enumeration_date": "2005-11-17",
        "last_updated": "2025-12-19",
        "certification_date": "2025-12-19",
        "status": "A",
        "authorized_official_last_name": "MORTON",
        "authorized_official_first_name": "DANA",
        "authorized_official_middle_name": "ROBYN",
        "authorized_official_title_or_position": "DIRECTOR CONTRACTING CREDENTIALING",
        "authorized_official_telephone_number": "903-614-3283"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CU0435",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "082240501",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Collom and Carney Clinic Urology",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Collom and Carney Clinic Urology",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Dec 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.