Collom & Carney Clinic

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

COLLOM & CARNEY CLINIC

Practice address

815 N Kings Hwy
Wake Village, TX 75501-5700

Phone

(903) 614-3937

Fax

(903) 832-7163

NPI assigned

Nov 17, 2005

Last updated

Feb 24, 2023By the provider in NPPES

Organization subpart

Yes

Parent organization

COLLOM & CARNEY CLINICAs reported in NPPES

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

Authorized official

Name

Mary E Dwight, CCS-P, MHA, CMPE

Title

Chief Operating Officer

Phone

(903) 614-3282

Specialties & licenses 1

Addresses

Other names 1

• Collom & Carney Westside Clinic Other name

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Part of

Collom Carney Clinic

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Collom & Carney Clinic

  • Durable Medical Equipment & Medical Supplies
  • Texarkana, TX
  • NPI 1437455565
  NPPES parent name

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

{
    "created_epoch": "1132185600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677196800000",
    "number": "1720060494",
    "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": "815 N KINGS HWY",
            "city": "WAKE VILLAGE",
            "state": "TX",
            "postal_code": "755015700",
            "telephone_number": "903-614-3937",
            "fax_number": "903-832-7163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLLOM & CARNEY CLINIC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COLLOM & CARNEY CLINIC",
        "enumeration_date": "2005-11-17",
        "last_updated": "2023-02-24",
        "certification_date": "2023-02-24",
        "status": "A",
        "authorized_official_last_name": "DWIGHT",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "903-614-3282",
        "authorized_official_credential": "CCS-P, MHA, CMPE"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Collom & Carney Westside Clinic",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Collom & Carney Westside Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Aspire Healthcare Solutions
• Tosha Blackmon, LVN
• Bryan D Bowen, MD
• Cecilia Cade
• Ansuk Cho
• Collom & Carney Clinic Association
• Ka'Leria Cunningham
• Aly Dixon
• Michael Chad Elliott, PA-C
• Global Home Security

• Durable Medical Equipment & Medical Supplies in Wake Village, TX
• Providers in Wake Village, TX by specialty
• Durable Medical Equipment & Medical Supplies in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.