Core Empowerment Group LLC

Primary specialty

Genetics Clinic/CenterTaxonomy code 261QG0250X

License

R-2220 Issued in AR

Legal business name

CORE EMPOWERMENT GROUP LLC

Practice address

17724 Interstate 30
Ste 2
Benton, AR 72019-2907

Phone

(501) 920-7901

Fax

(501) 325-3469

NPI assigned

Jul 3, 2009

Organization subpart

No

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

Authorized official

Name

Dr. William R Collie IV, M.D.

Title

Coo

Phone

(501) 920-7901

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1246579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1246579200000",
    "number": "1962631523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 MILITARY RD",
            "address_2": "STE 2 PMB 269",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "720152908",
            "telephone_number": "501-920-7901",
            "fax_number": "501-325-3469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17724 INTERSTATE 30",
            "address_2": "STE 2",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "720192907",
            "telephone_number": "501-920-7901",
            "fax_number": "501-325-3469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORE EMPOWERMENT GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-03",
        "last_updated": "2009-07-03",
        "status": "A",
        "authorized_official_last_name": "COLLIE",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "501-920-7901",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "IV",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QG0250X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Genetics",
            "state": "AR",
            "license": "R-2220",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Juana Copta-Vaughan, LPN
• Sara Megan Corbishley, PLMSW
• Laura Corbo, RECOVERY ASSISTANT
• Angela Corder, RECOVERY ASSISTANT
• Frank Cordova
• Stacie Michelle Cornwell, MSED
• Olen Cossey, LPN
• Jana Cotton, QBHP
• Adrian Cottrell
• Coulter Technical Services Inc

• Clinic/Center in Benton, AR
• Providers in Benton, AR by specialty
• Clinic/Center in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2009; 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.