NPIMap

Individual provider Active NPI

Candy Sadler, AGNP

  • Adult Health Nurse Practitioner
  • Rolla, MO
National Provider Identifier
1043761521
Registry record updated Apr 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
2016037537 Issued in MO
Practice address
1000 W 10TH St
Rolla, MO 65401-2905
Phone
(573) 364-9000
Fax
(573) 426-2108
NPI assigned
Oct 19, 2016
Last updated
Apr 17, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 2016037537 MO Primary

Addresses

Primary practice location

1000 W 10TH St
Rolla, MO 65401-2905

Mailing address

1050 W 10TH St
Rolla, MO 65401-2905
Phone (573) 364-9000

Other practice location 1

1000 W 10th St
Rolla, MO 65401-2905
Phone (573) 458-8899

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161111000833 MO Practitioner - Nurse Practitioner 7113206376 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pcrmc Medical Group IncGroup PAC ID 1557454063, 113 clinicians

Practice addresses (Care Compare)

1000 W 10TH St
Rolla, MO 65401-2905
Phone (573) 364-9000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2016037537MOMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pcrmc Medical Group, Inc CurrentSince Oct 27, 2016 Accepting new patients
Phelps County Regional Medical Center CurrentSince Oct 27, 2016 Accepting new patients
Phelps County Regional Medical Center CurrentSince Apr 13, 2024 Accepting new patients

Locations

1000 W 10th St
Rolla, MO 65401
Phone (573) 364-9000

1050 W 10th St
Rolla, MO 65401
Phone (573) 364-9000

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1476835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744848000000",
    "number": "1043761521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 W 10TH ST",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "654012905",
            "telephone_number": "573-364-9000",
            "fax_number": "573-426-2108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 W 10TH ST",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "654012905",
            "telephone_number": "573-364-9000",
            "fax_number": "573-426-2108"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 W 10th St",
            "address_purpose": "LOCATION",
            "city": "Rolla",
            "state": "MO",
            "postal_code": "654012905",
            "country_code": "US",
            "telephone_number": "573-458-8899",
            "fax_number": "573-341-5611",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SADLER",
        "first_name": "CANDY",
        "name_prefix": "Ms.",
        "credential": "AGNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-19",
        "last_updated": "2025-04-17",
        "certification_date": "2025-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MO",
            "license": "2016037537",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rolla, MO

Sources for this page

Verify at the official NPI Registry.