COLLOM & CARNEY WESTSIDE CLINIC
NPI 1720060494
Durable Medical Equipment & Medical Supplies in Wake Village, TX

NPI Status: Active since November 17, 2005

Contact Information

815 N KINGS HWY
WAKE VILLAGE, TX
ZIP 75501
Phone: (903) 614-3937
Fax: (903) 832-7163

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  • Organization
  • Durable Medical Equipment & Medical Supp...
  • CLIA Number: 45D0482327
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 12-29-2027

About COLLOM & CARNEY WESTSIDE CLINIC

This page provides the complete NPI Profile along with additional information for Collom & Carney Westside Clinic, a provider established in Wake Village, Texas operating as a Durable Medical Equipment & Medical Supplies. The healthcare provider is registered in the NPI registry with number 1720060494 assigned on November 2005. The practitioner's primary taxonomy code is 332B00000X. The provider is registered as an organization and their NPI record was last updated 3 years ago. The provider's other name is Collom & Carney Westside Clinic. The authorized official of this NPI record is Mary E Dwight Ccs-p, Mha, Cmpe (Chief Operating Officer)

NPI
1720060494
Provider Legal Name
COLLOM & CARNEY CLINIC
Other Organization Name
COLLOM & CARNEY WESTSIDE CLINIC
Other Name Type
Other Name (5)
Entity Type
Organization
Location Address
815 N KINGS HWY WAKE VILLAGE, TX 75501
Location Phone
(903) 614-3937
Location Fax
(903) 832-7163
Mailing Address
5002 COWHORN CREEK RD TEXARKANA, TX 75503
Mailing Phone
(903) 614-3000
Mailing Fax
(903) 832-7163
Is Sole Proprietor?
No
Is Organization Subpart?
Yes
Enumeration Date
11-17-2005
Last Update Date
02-24-2023
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Durable Medical Equipment & Medical Supplies

Taxonomy Code
332B00000X
Type
Suppliers
Taxonomy Description
A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MARY E DWIGHT CCS-P, MHA, CMPE

Authorized Official Title
CHIEF OPERATING OFFICER
Authorized Official Phone
(903) 614-3282

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
45D0482327
Facility Type
Physician Office
Certificate Effective Date
December 30, 2025
Certificate Expiration Date
December 29, 2027
Laboratory Director
CARLA ROSE MT ASCP
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Collom & Carney Westside Clinic to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1720060494, we treat the final digit (4) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 56. The final step is to find the difference between that total and the next multiple of ten (60 - 56 = 4).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
7
Unchanged
Pos 3
2
Doubled → 4
Pos 4
0
Unchanged
Pos 5
0
Doubled → 0
Pos 6
6
Unchanged
Pos 7
0
Doubled → 0
Pos 8
4
Unchanged
Pos 9
9
Doubled → 18 → 1 + 8
Check
4
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 2 → 4 0 → 0 0 → 0 9 → 18 → 9

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 7 + 4 + 0 + 0 + 6 + 0 + 4 + 1 + 8 + 24 = 56

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 56 is 60. The difference is the calculated check digit.

60 - 56 = 4
This NPI is valid
The calculated check digit is 4, which matches the last digit of 1720060494.

Other Providers at the Same Location


The following 6 providers are registered at the same or a nearby location.

Family Medicine
815 N KINGS HWY
TEXARKANA, TX 75501
Family Medicine
815 N KINGS HWY
WAKE VILLAGE, TX 75501
Nurse Practitioner (Family)
815 N KINGS HWY
WAKE VILLAGE, TX 75501
Family Medicine
815 N KINGS HWY
WAKE VILLAGE, TX 75501
Nurse Practitioner (Family)
815 N KINGS HWY
WAKE VILLAGE, TX 75501
Nurse Practitioner (Family)
815 N KINGS HWY
WAKE VILLAGE, TX 75501

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1720060494, enumerated as an "organization" on November 17, 2005.

The provider is located at 815 N KINGS HWY WAKE VILLAGE, TX 75501 and the phone number is (903) 614-3937.

Durable Medical Equipment & Medical Supplies with taxonomy code 332B00000X.