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

Miller County Dialysis Unit

Practice address

816 East St.
Texarkana, AR 71854

Phone

(870) 772-2756

Fax

(870) 772-2784

NPI assigned

Jul 3, 2006

Organization subpart

No

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

Authorized official

Name

Pat Roberts

Title

Administrator

Phone

(903) 614-3601

Specialties & licenses 1

Addresses

Other names 1

• Miller County Dialysis Unit Doing business as

Locations

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534464000000",
    "number": "1871523480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "816 EAST ST.",
            "city": "TEXARKANA",
            "state": "AR",
            "postal_code": "71854",
            "telephone_number": "870-772-2756",
            "fax_number": "870-772-2784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "816 EAST ST.",
            "city": "TEXARKANA",
            "state": "AR",
            "postal_code": "71854",
            "telephone_number": "870-772-2756",
            "fax_number": "870-772-2784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLLOM & CARNEY CLINIC ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-03",
        "last_updated": "2018-08-17",
        "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"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Miller County Dialysis Unit",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Shalundrea Lavaughn Cleveland
• Cyndee Cline
• CMG Family Clinic of Texarkana
• Gretchen Cobb, BSE
• Kimberly Jean Coffman
• Sheryl Ann Collum, CASE MANAGER/MHPP
• Larry Cottingham
• Mandilyn Kay Cottingham, FNP-BC
• Stephanie Cottle, RN
• Cecil Ray Cowan III, M.D.

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Texarkana, AR
• Providers in Texarkana, 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 Aug 17, 2018; 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.