Individual provider Active NPI

Candi Christine Ives, RN

  • Registered Nurse
  • Nespelem, WA
National Provider Identifier
1053583641
Registry record updated Mar 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN00173786 Issued in WA
Practice address
19 Lakes Street
Nespelem, WA 99155-0071
Phone
(509) 634-2900
Fax
(509) 634-2981
NPI assigned
Mar 24, 2008
Sex
Female
Sole proprietor
Yes

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN00173786WAMDRegistered Nurse

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN00173786 WA Primary

Addresses

NPPES NPI Registry

Primary practice location

19 Lakes Street
Nespelem, WA 99155-0071

Mailing address

19 Lakes Street
Nespelem, WA 99155-0071
Phone (509) 634-2900

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
7139470MedicaidWA

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 24, 2008.

{
    "created_epoch": "1206316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206316800000",
    "number": "1053583641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 LAKES STREET",
            "city": "NESPELEM",
            "state": "WA",
            "postal_code": "991550071",
            "telephone_number": "509-634-2900",
            "fax_number": "509-634-2981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 LAKES STREET",
            "city": "NESPELEM",
            "state": "WA",
            "postal_code": "991550071",
            "telephone_number": "509-634-2900",
            "fax_number": "509-634-2981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IVES",
        "first_name": "CANDI",
        "middle_name": "CHRISTINE",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-03-24",
        "last_updated": "2008-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN00173786",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7139470",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nespelem, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2008; 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.