Individual provider Active NPI

Candyce Waszmer, MSW

  • Social Worker
  • Clarksville, TN
National Provider Identifier
1043623481
Registry record updated Jun 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
TIN 20-3858944 Issued in TN
Practice address
1820 Memorial Dr Ste 203
Clarksville, TN 37043-4693
Phone
(931) 933-7200
NPI assigned
Jun 3, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X TIN 20-3858944 TN Primary

Addresses

Primary practice location

1820 Memorial Dr Ste 203
Clarksville, TN 37043-4693

Mailing address

1820 Memorial Dr Ste 203
Clarksville, TN 37043-4693
Phone (931) 933-7200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
TIN 20-3858944TNMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1401753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401753600000",
    "number": "1043623481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1820 MEMORIAL DR STE 203",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370434693",
            "telephone_number": "931-933-7200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1820 MEMORIAL DR STE 203",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370434693",
            "telephone_number": "931-933-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASZMER",
        "first_name": "CANDYCE",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-03",
        "last_updated": "2014-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "TN",
            "license": "TIN 20-3858944",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarksville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.