Active NPI
Candice S Campbell, N.P.
- Women's Health Nurse Practitioner
- Indianapolis, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Women's Health Nurse Practitioner
- License
- 28164598A
- Practice address
- 7150 Clearvista Dr
Indianapolis, IN 46256-1695 - Phone
- (317) 621-5890
- NPI assigned
- Mar 26, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Women's Health Nurse Practitioner | 363LW0102X | 28164598A | IN | Primary |
Addresses
Primary practice location
7150 Clearvista Dr
Indianapolis, IN 46256-1695
Mailing address
6626 E 75TH St
Ste 500
Indianapolis, IN 46250-2805
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CAM104363128 | Other | IN | NCC |
| P01512395 | Other | IN | MEDICARE RR |
| 201059440 | Medicaid | IN |
Other names 1
- Candice S Erick
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | ccampbell170672@eCommunityDirect.com | Community Physicians of Indiana Inc |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
7150 Clearvista Dr
Indianapolis, IN 46256-1695
Phone (317) 621-6262
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28164598A | IN | MD | Women's Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Physicians of Indiana Inc | Current | Accepting new patients | |
| Community Physicians of Indiana Inc | Current | Accepting new patients |
Locations
5819 Reliable Pkwy
Chicago, IL 60686
6626 E 75th St
Ste 500
Indianapolis, IN 46250
Phone (317) 621-7547
7150 Clearvista Dr
Indianapolis, IN 46256
Phone (317) 355-5041
7120 Clearvista Dr
Ste 4000
Indianapolis, IN 46256
Phone (317) 621-7444
Interoperability endpoints
- ccampbell170672@ecommunitydirect.com
Organizations & group practices 2
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.
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- NPI 1992396337
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1332720000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701043200000",
"number": "1053687988",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6626 E 75TH ST",
"address_2": "STE 500",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462502805"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7150 CLEARVISTA DR",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462561695",
"telephone_number": "317-621-5890"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAMPBELL",
"first_name": "CANDICE",
"middle_name": "S",
"credential": "N.P.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-03-26",
"last_updated": "2023-11-27",
"certification_date": "2020-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "363LW0102X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Women's Health",
"state": "IN",
"license": "28164598A",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NCC",
"identifier": "CAM104363128",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RR",
"identifier": "P01512395",
"state": "IN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "201059440",
"state": "IN"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "ccampbell170672@eCommunityDirect.com",
"affiliation": "Y",
"affiliationName": "Community Physicians of Indiana Inc",
"address_1": "7150 Clearvista Dr",
"city": "Indianapolis",
"state": "IN",
"country_code": "US",
"postal_code": "462561695",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "CANDICE",
"last_name": "ERICK",
"middle_name": "S",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.