Individual provider Active NPI

Candace Lynn Walkley, M.D.

  • Internal Medicine Physician
  • Conroe, TX
National Provider Identifier
1013939560
Registry record updated Apr 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
R2781 Issued in TX
Practice address
1169 Grand Central Pkwy BLDG E
Conroe, TX 77304-3185
Phone
(936) 525-3600
NPI assigned
Jul 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X 023916 LA
Internal Medicine Physician 207R00000X R2781 TX Primary

Addresses

Primary practice location

1169 Grand Central Pkwy BLDG E
Conroe, TX 77304-3185

Mailing address

1169 Grand Central Pkwy BLDG E
Conroe, TX 77304-3185
Phone (936) 525-3600

Other names 1

  • Candace Lynn Mitchell Former name

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
I20170905001988 TX Practitioner - Internal Medicine 0547167892 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Texas Southwestern Medical School at Dallas, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sam Houston State UniversityGroup PAC ID 8123451135, 13 clinicians

Practice addresses (Care Compare)

1169 Grand Central Pkwy
Conroe, TX 77304-3185
Phone (936) 525-3600

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
023916LAMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kelsey-Seybold Medical Group, PLLC Internal Medicine CurrentSince Aug 1, 2023 Accepting new patients
Sam Houston State University Internal Medicine CurrentSince Nov 12, 2019 Accepting new patients
Sam Houston State University PastSince Nov 12, 2019 Accepting new patients

Locations

1169 Grand Central Pkwy
Conroe, TX 77304
Phone (936) 525-3600

1169 Grand Central Pkwy
Bldg E
Conroe, TX 77304
Phone (936) 525-3600

100 Medical Center Pkwy
Ste 1000
Huntsville, TX 77340
Phone (936) 295-8000

100 Medical Center Pkwy
Huntsville, TX 77340
Phone (936) 293-8800

Interoperability endpoints

  • Direct secure messaging: candace.walkley.1@20228.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/20228/brand/1/csg/1/fhir/r4

Organizations & group practices 3

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

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": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712188800000",
    "number": "1013939560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1169 GRAND CENTRAL PKWY BLDG E",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773043185",
            "telephone_number": "936-525-3600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1169 GRAND CENTRAL PKWY BLDG E",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773043185",
            "telephone_number": "936-525-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKLEY",
        "first_name": "CANDACE",
        "middle_name": "LYNN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-24",
        "last_updated": "2024-04-04",
        "certification_date": "2024-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "LA",
            "license": "023916",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "R2781",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CANDACE",
            "last_name": "MITCHELL",
            "middle_name": "LYNN",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Conroe, TX

Sources for this page

Verify at the official NPI Registry.