Candice Mae Lancaster, DPT

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

11969 Issued in TN

Practice address

41818 N Venture Dr Ste 120
Anthem, AZ 85086-3189

Phone

(623) 742-7338

Fax

(623) 742-7339

NPI assigned

Jan 20, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Arizona Luna Care Physical Therapy, LLC

  • Physical Therapist
  • Peoria, AZ
  • NPI 1629698147

  Single Specialty

  Medicare reassignment NPD
• Desert Edge Physical Therapy LLC

  • Physical Therapy Clinic/Center
  • Peoria, AZ
  • NPI 1710487707

  Single Specialty

  Medicare reassignment NPD
• Harper Physical Therapy Inc

  • Physical Therapist
  • Anthem, AZ
  • NPI 1043380918

  Single Specialty

  Medicare reassignment NPD

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

{
    "created_epoch": "1547942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547942400000",
    "number": "1063986362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23602 N 83RD ST",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852553533",
            "telephone_number": "662-769-2269",
            "fax_number": "623-742-7338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41818 N VENTURE DR STE 120",
            "city": "ANTHEM",
            "state": "AZ",
            "postal_code": "850863189",
            "telephone_number": "623-742-7338",
            "fax_number": "623-742-7339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANCASTER",
        "first_name": "CANDICE",
        "middle_name": "MAE",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-20",
        "last_updated": "2019-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "TN",
            "license": "11969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephen Kittridge, LCSW
• Robert Bradley Kohl, DDS
• Tatum Kolicko
• Daniel Gregory Koman, DDS
• La Pietra Geralyn La Pietra, M.S., CCC-SLP
• Landmark Medical LLC
• George Langford
• Lasting Smiles of Anthem LLC
• Sung Ae Lee, M.D.
• Legacy Behavioral Health,LLC

• Physical Medicine & Rehabilitation Physician in Anthem, AZ
• Providers in Anthem, AZ by specialty
• Physical Medicine & Rehabilitation Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.