Kandace Danielle Bivens, PA-C
Individual provider Active NPI Medical Physician Assistant · Milledgeville, GA
NPI 1003073990 · NPPES record last updated Mar 2, 2025
Key facts
- NPI
- 1003073990
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Medical Physician Assistant 363AM0700X
- License
- 1722 (GA)
- Practice address
- 800 W Thomas St
Milledgeville, GA 31061-2674 - Phone
- (478) 453-9346
- NPI assigned
- May 19, 2008
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- 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 |
|---|---|---|---|---|
| I20110713000688 | GA | Practitioner - Physician Assistant | 9739357922 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1722 | GA | MD | Physical Medicine & Rehabilitation Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Oconee Family Medicine Center, PC | Current |
Accepting new patients | |
| Washington County Internal Medicine, P.C. | Past |
Accepting new patients |
Locations
800 W Thomas St
Milledgeville, GA 31061
Phone (478) 453-9346
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/JAFJAD
- https://fhir-myrecord.cerner.com/r4/cPXkxGWnH-HHwThIezCJp4EJYz7iHU2Y/
- https://fhir4.healow.com/fhir/r4/JAFJAD/Endpoint/JAFJAD
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 1722 | GA | Yes |
Addresses
Primary practice location
800 W Thomas St
Milledgeville, GA 31061-2674
Mailing address
800 W Thomas St
Milledgeville, GA 31061-2674
Phone (478) 453-9346
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 899248448A | Medicaid | GA | |
| 899248448B | Medicaid | GA |
Other names
- Miss Kandace Danielle Allen Markham
Other providers in Milledgeville, GA
- Wendy Arlene Bell
- Kayla Bennett
- Theresa Betts
- Tayyab Fayyaz Bhutta
- Bio-Medical Applications of Georgia, Inc.
- Jaimie Lynn Blackwell
- Madilyn Harrington Blizzard
- Parker Rhett Blizzard
- Lisha Bly
- Patrice D Boddie
All providers in Milledgeville, GA · Medical Physician Assistant in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 2, 2025. 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).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.