Kevin Henderson O'Sullivan, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

E-11617 Issued in AR

Practice address

1307 Trinity Blvd
Texarkana, AR 71854-8310

Phone

(870) 773-6467

Fax

(870) 216-0061

NPI assigned

Mar 28, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AR, TX2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Family Practice

Education

University of Arkansas College of Medicine, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Collom and Carney Clinic AssociationGroup PAC ID 1355249541, 52 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Encompass Health Home Health Home health agency, Texarkana, AR, CCN 047168
• Elite Home Health Home health agency, Nashville, AR, CCN 047138
• Dierksen Memorial Hospice Hospice, Texarkana, AR, CCN 041572
• Christus St Michael Health System Hospital, Texarkana, TX, CCN 450801
• Southwest Regional Medical Center LLC Hospital, Hope, AR, CCN 041335
• Little River Memorial Hospital Hospital, Ashdown, AR, CCN 041320

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kevin.osullivan.p1@direct.collom-carney.nextgenshare.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Collom & Carney Clinic Association

  • Family Medicine Physician
  • Prescott, AR
  • NPI 1740262732

  AR, Family Medicine

  Medicare reassignment Care Compare group NPD
• Collom & Carney Clinic Association

  • Hematology & Oncology Physician
  • Texarkana, TX
  • NPI 1114909934

  TX

  Medicare reassignment Care Compare group NPD
• Collom & Carney Clinic Association

  • Clinical Medical Laboratory
  • Texarkana, TX
  • NPI 1164405296
  Care Compare group NPD
• Collom & Carney Clinic Association

  • Nephrology Physician
  • Texarkana, TX
  • NPI 1265414635
  Care Compare group NPD
• Collom & Carney Clinic Association

  • Pain Medicine (Anesthesiology) Physician
  • Texarkana, TX
  • NPI 1962829747
  Care Compare group NPD
• Permian Premier Health Services Inc

  • Contractor
  • Odessa, TX
  • NPI 1285664763

  AR

  Medicare reassignment
• Collom & Carney Clinic Association

  • Durable Medical Equipment & Medical Supplies
  • Texarkana, TX
  • NPI 1295929743
  Care Compare group
• Collom & Carney Clinic Association

  • Durable Medical Equipment & Medical Supplies
  • Texarkana, TX
  • NPI 1750364899
  Care Compare group
• Collom & Carney Clinic Association

  • Cardiovascular Disease Physician
  • Texarkana, TX
  • NPI 1013252279
  NPD
• Collom & Carney Clinic Association

  • Family Medicine Physician
  • Texarkana, TX
  • NPI 1285616805

  Family Medicine

  NPD
• Collom and Carney Clinic Association

  • Neurology Physician
  • Texarkana, TX
  • NPI 1215918693
  NPD (past)
• Collom and Carney Clinic Association

  • Clinic/Center
  • Texarkana, TX
  • NPI 1871575514
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Ahm Action Home Health, LP

  • Home Health Agency
  • Texarkana, AR
  • NPI 1780076208
  Care Compare affiliation
• Dierksen of Texarkana Arkansas LLC

  • Community Based Hospice Care Agency
  • Texarkana, AR
  • NPI 1104088632

  Hospice

  Care Compare affiliation
• Little River Medical Center, Inc.

  • Critical Access Hospital
  • Ashdown, AR
  • NPI 1326040007

  Hospital

  Care Compare affiliation
• Southwest Arkansas Homecare, LLC

  • Home Health Agency
  • Nashville, AR
  • NPI 1881892404
  Care Compare affiliation
• Southwest Arkansas Regional Medical Center, LLC

  • Critical Access Hospital
  • Hope, AR
  • NPI 1164234308

  Hospital

  Care Compare affiliation
• Christus Health Ark-la-Tex

  • General Practice Physician
  • Texarkana, TX
  • NPI 1184623266

  Hospital

  Care Compare affiliation
• Christus Health Ark-la-Tex

  • General Acute Care Hospital
  • Texarkana, TX
  • NPI 1295736734

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1427500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655683200000",
    "number": "1922492859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1307 TRINITY BLVD",
            "city": "TEXARKANA",
            "state": "AR",
            "postal_code": "718548310",
            "telephone_number": "870-779-6093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1307 TRINITY BLVD",
            "city": "TEXARKANA",
            "state": "AR",
            "postal_code": "718548310",
            "telephone_number": "870-773-6467",
            "fax_number": "870-216-0061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'SULLIVAN",
        "first_name": "KEVIN",
        "middle_name": "HENDERSON",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-28",
        "last_updated": "2022-06-20",
        "certification_date": "2022-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E-11617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Texarkana, AR
• Family Medicine Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.