Active NPI
Candy Lucero-Palma, NP
- Critical Care Medicine (Internal Medicine) Physician
- Kendallville, IN
National Provider Identifier
1063290823
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Critical Care Medicine (Internal Medicine) Physician
- License
- 28237752A
- Practice address
- 1844 Ida Red Rd
Kendallville, IN 46755-2873 - Phone
- (260) 347-8810
- NPI assigned
- Sep 21, 2023
- 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 |
|---|---|---|---|---|
| Critical Care Medicine (Internal Medicine) Physician | 207RC0200X | 28237752A | IN | Primary |
Addresses
Primary practice location
1844 Ida Red Rd
Kendallville, IN 46755-2873
Mailing address
11109 Parkview Plaza Dr # 117
Fort Wayne, IN 46845-1701
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
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28237752A | IN | MD | Critical Care Medicine (Internal Medicine) Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1695254400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1695254400000",
"number": "1063290823",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11109 PARKVIEW PLAZA DR # 117",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468451701"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1844 IDA RED RD",
"city": "KENDALLVILLE",
"state": "IN",
"postal_code": "467552873",
"telephone_number": "260-347-8810"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUCERO-PALMA",
"first_name": "CANDY",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-09-21",
"last_updated": "2023-09-21",
"certification_date": "2023-09-21",
"status": "A"
},
"taxonomies": [
{
"code": "207RC0200X",
"taxonomy_group": "",
"desc": "Internal Medicine, Critical Care Medicine",
"state": "IN",
"license": "28237752A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kendallville, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.