Individual provider Active NPI

Herman L. Kile Jr., MD

  • Family Medicine Physician
  • Texarkana, TX
National Provider Identifier
1992775100
Registry record updated Apr 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
K0091 Issued in TX
Practice address
5002 Cowhorn Creek Rd
Texarkana, TX 75503-9766
Phone
(903) 614-3000
Fax
(903) 614-3525
NPI assigned
Jan 23, 2006
Last updated
Apr 8, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X E0680 AR
Family Medicine Physician 207Q00000X K0091 TX Primary

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 3

IdentifierTypeStateIssuer
129225001MedicaidAR
5J931OtherARBLUE CROSS BLUE SHIELD
8R6600OtherTXBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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 1

Enrollment IDStateProvider typePAC IDDetails
I20090826000112 TX Practitioner - Family Practice 2062495906 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Louisiana State University School of Medicine in Shreveport, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

815 N King Hwy
Texarkana, TX 75501-5700
Phone (903) 614-3700

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
E0680ARMDFamily Medicine Physician
K0091TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew 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 CurrentSince Sep 1, 2009 Accepting new patients
Collom & Carney Clinic Association Family Medicine CurrentSince Sep 1, 2009 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

1420 S Constitution Ave
Ashdown, AR 71822
Phone (870) 898-2797

1440 W 1st St N
Prescott, AR 71857
Phone (501) 777-2131

2602 Saint Michael Dr
Texarkana, TX 75503
Phone (903) 614-6000

2931 Richmond Rd
Texarkana, TX 75503
Phone (903) 614-3200

5002 Cowhorn Creek Rd
Texarkana, TX 75503
Phone (903) 614-3008

815 N Kings Hwy
Wake Village, TX 75501
Phone (903) 614-3700

Interoperability endpoints

  • Direct secure messaging: hlawson.kile.p1@direct.collom-carney.nextgenshare.com

Organizations & group practices 8

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

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1137974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302220800000",
    "number": "1992775100",
    "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": "KILE",
        "first_name": "HERMAN",
        "middle_name": "L.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-23",
        "last_updated": "2011-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E0680",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "K0091",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "129225001",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "5J931",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "8R6600",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Texarkana, TX

Sources for this page

Verify at the official NPI Registry.