Brandi Langdon, FNP
Individual provider Active NPI Family Nurse Practitioner · Texarkana, TX
NPI 1962402867 · NPPES record last updated Sep 18, 2015
Key facts
- NPI
- 1962402867
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 595574 (TX)
- Practice address
- 5002 Cowhorn Creek Rd
Texarkana, TX 75503-9766 - Phone
- (903) 614-3000
- Fax
- (903) 614-3525
- NPI assigned
- Jul 21, 2005
- Reactivated
- Mar 28, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 11
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Collom and Carney Clinic Association
Practice addresses (Care Compare)
5002 Cowhorn Creek Rd
Texarkana, TX 75503-9766
Phone (903) 614-3000
Hospital & facility affiliations
- Onesource Home Care Inc
- Christus St Michael Health System
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100109000389 | TX | Practitioner - Nurse Practitioner | 1850432014 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A01367 | AR | MD | Family Nurse Practitioner |
| 595574 | TX | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Collom & Carney Clinic Association | Current |
Accepting new patients | |
| Collom & Carney Clinic Association | Current |
Accepting new patients | |
| Collom & Carney Clinic Association | Current | Accepting new patients | |
| Collom & Carney Clinic Association | Current | Accepting new patients | |
| Collom & Carney Clinic Association | Current | Accepting new patients | |
| Collom & Carney Clinic Association | Current | Accepting new patients | |
| Collom and Carney Clinic Association | Past | Accepting new patients | |
| Collom and Carney Clinic Association | Past | Accepting new patients |
Locations
1440 W 1st St N
Prescott, AR 71857
Phone (501) 777-2131
5002 Cowhorn Creek Rd
Texarkana, TX 75503
Phone (903) 614-3008
2931 Richmond Rd
Texarkana, TX 75503
Phone (903) 614-3200
Interoperability endpoints
- brandi.langdon.p1@direct.collom-carney.nextgenshare.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 595574 | TX | Yes |
| Family Nurse Practitioner | 363LF0000X | A01367 | AR |
Addresses
Primary practice location
5002 Cowhorn Creek Rd
Texarkana, TX 75503-9766
Mailing address
5002 Cowhorn Creek Rd
Texarkana, TX 75503-9766
Phone (903) 614-3000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00065624 | Other | RAILROAD MEDICINE | |
| 140846758 | Medicaid | AR |
NPI Registry JSON
{
"created_epoch": "1121904000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1442534400000",
"number": "1962402867",
"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": "5002 COWHORN CREEK RD",
"city": "TEXARKANA",
"state": "TX",
"postal_code": "755039766",
"telephone_number": "903-614-3000",
"fax_number": "903-614-3525"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LANGDON",
"first_name": "BRANDI",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-07-21",
"last_updated": "2015-09-18",
"deactivation_date": "2006-03-21",
"reactivation_date": "2006-03-28",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "TX",
"license": "595574",
"primary": true
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "AR",
"license": "A01367",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICINE",
"identifier": "P00065624",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "140846758",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Texarkana, TX
- Patrizia Lalonde
- Zachary Dylan Lamkin
- Tara Lamm
- Melissa Ann Lamon
- Jamie Shari Landreth
- Lansdell Family Clinic PLLC
- Barbara Larry
- Taylor B Laster
- Launch Pediatric Physical Therapy, PLLC
- Amy Danielle Lawing
All providers in Texarkana, TX · Family Nurse Practitioner in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 18, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.