Individual provider Active NPI

Candace M Carr, C.N.S.

  • Clinical Nurse Specialist
  • Tulsa, OK
National Provider Identifier
1083685135
Registry record updated Oct 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Nurse SpecialistTaxonomy code 364S00000X
License
R0051791 Issued in OK
Practice address
1265 S Utica Ave
Suite 300
Tulsa, OK 74104-4243
Phone
(918) 592-0999
Fax
(918) 592-1021
NPI assigned
Jan 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Nurse Specialist 364S00000X R0051791 OK Primary

Addresses

Primary practice location

1265 S Utica Ave
Suite 300
Tulsa, OK 74104-4243

Mailing address

9228 S Mingo Rd
Suite 200
Tulsa, OK 74133-5718
Phone (918) 592-0999

Other identifiers 4

IdentifierTypeStateIssuer
P00117501OtherOKMEDICARE RAILROAD
100850620AMedicaidOK
OK400768OtherOKMEDICARE PTAN
P00611404OtherOKMEDICARE RAILROAD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040317000606 OK Practitioner - Certified Clinical Nurse Specialist (CNS) 1850281577 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Clinical Nurse Specialist (CNS)
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ahs Oklahoma Heart LLCGroup PAC ID 4587737135, 130 clinicians

Practice addresses (Care Compare)

1120 S Utica Ave
Tulsa, OK 74104-4012
Phone (918) 592-0999

9228 S Mingo Rd
Suite 200
Tulsa, OK 74133-5722
Phone (918) 592-0999

Hospital & facility affiliations

  • Hillcrest Medical Center Hospital, Tulsa, OK, CCN 370001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Specialist

State licenses

LicenseStateTypeSpecialty
R0051791OKMDClinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Ahs Oklahoma Heart LLC CurrentSince Apr 16, 2008 Accepting new patients
Oklahoma Heart Inc Past Accepting new patients
Integris Cardiovascular Physicians LLC Past Accepting new patients
Cardiology of Tulsa Inc. Dba Cardiology Diagnostics of Tulsa Past Accepting new patients

Locations

1265 S Utica Ave
Ste 300
Tulsa, OK 74104
Phone (918) 855-2570

9228 S Mingo Rd
Ste 200
Tulsa, OK 74133
Phone (918) 574-9820

Dept 1218
Tulsa, OK 74182

Interoperability endpoints

  • Direct secure messaging: ccarr106909@ahs.direct-ci.com
  • FHIR API: https://epicproxy.ardenthealth.com/fhir/OHI/api/FHIR/R4

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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": "1138320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225152000000",
    "number": "1083685135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9228 S MINGO RD",
            "address_2": "SUITE 200",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741335718",
            "telephone_number": "918-592-0999",
            "fax_number": "918-878-2499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1265 S UTICA AVE",
            "address_2": "SUITE 300",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741044243",
            "telephone_number": "918-592-0999",
            "fax_number": "918-592-1021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARR",
        "first_name": "CANDACE",
        "middle_name": "M",
        "credential": "C.N.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-27",
        "last_updated": "2008-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364S00000X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist",
            "state": "OK",
            "license": "R0051791",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00117501",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100850620A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "OK400768",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00611404",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.