CORE EMPOWERMENT GROUP LLC (NPI# 1962631523) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962631523 |
| Entity Type | Organization |
| Organization Name | CORE EMPOWERMENT GROUP LLC |
| Practice Address |
17724 Interstate 30 Ste 2 Benton AR 72019-2907 |
| Mailing Address |
1201 Military Rd Ste 2 Pmb 269 Benton AR 72015-2908 |
| Practice Telephone | 5019207901 |
| Practice Fax Number | 5013253469 |
| Mailing Telephone | 5019207901 |
| Mailing Fax Number | 5013253469 |
| Enumeration Date | 2009-07-03 |
| Last Update Date | 2009-07-03 |
| Authorized Official Name | DR. WILLIAM R COLLIE IV (COO) |
| Authorized Official Telephone | 5019207901 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QG0250X |
Clinic/Center Specialization: Genetics |
R-2220 | AR | Ambulatory Health Care Facilities |
| Street Address |
17724 INTERSTATE 30 STE 2 |
| City | BENTON |
| State | AR |
| Zip Code | 72019-2907 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497923155 | William Richard Collie Iv | Medical Genetics | 17724 Interstate 30, Ste 2, Benton, AR 72019-2907 | 2008-02-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841898293 | Arkansas Heart Hospital LLC | General Acute Care Hospital | 1901 Encore Way, Bryant, AR 72019 | 2020-10-16 |
| 1306485545 | Ryan Adams | Pharmacist | 20820 I-30 North, Benton, AR 72019 | 2020-01-06 |
| 1649819962 | Josh Landrum | Pharmacist | 20820 I 30 N, Benton, AR 72019 | 2020-01-03 |
| 1710525720 | Melanie Mabry | Nurse Practitioner | 11510 State Highway 298, Benton, AR 72019 | 2019-12-20 |
| 1578086864 | Ronald Winkler | Occupational Therapy Assistant | 2907 Hurricane Lake Rd, Bryant, AR 72019 | 2017-07-19 |
| 1801243357 | Richard Andrew Dwiggins | Social Worker | 1718 Old Hot Springs Highway, Benton, AR 72019 | 2016-05-14 |
| 1184008377 | Kroger Limited Partnership I | Durable Medical Equipment & Medical Supplies | 2080 I-30 North, Benton, AR 72019 | 2015-07-17 |
| 1689910051 | Rachel Cloud | Physical Therapist | 2010 Activeway, Benton, AR 72019 | 2012-12-12 |
| 1538444583 | Stacy Ann Harris | Specialist | 403 Demuth Lane, Benton, AR 72019 | 2011-10-20 |
| 1144528423 | Robert Mark Robinson | Licensed Practical Nurse | 5 Hickory Ridge Drive, Benton, AR 72019 | 2011-03-10 |
| Find all providers in zip 72019 | ||||
| Taxonomy Code | 261QG0250X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Genetics |
| An entity, facility, or distinct part of a facility providing analysis of family history, genetic laboratory testing and analysis, diagnosis of genetic trait, prognosis and options. Laboratory studies may be outsourced. |
| Notes: [7/1/2003: new] |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.