Individual provider Active NPI

Candace Herrin, APRN-CNP

  • Family Nurse Practitioner
  • Guthrie, OK
National Provider Identifier
1114544871
Registry record updated Jun 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R0099589 Issued in OK
Practice address
1201 S Division St
Guthrie, OK 73044-5021
Phone
(405) 293-4504
NPI assigned
Jun 29, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R0099589 OK Primary

Addresses

Primary practice location

1201 S Division St
Guthrie, OK 73044-5021

Mailing address

890 S Sandpiper Nest
Choctaw, OK 73020-7012
Phone (405) 625-3873

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
I20200727000797 OK Practitioner - Nurse Practitioner 2163846908 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

13511 NE 23Rd St
Suite 140
Choctaw, OK 73020-8625
Phone (405) 591-3584

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R0099589OKMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hometown Primary Care, PLLC CurrentSince Jul 7, 2022 Accepting new patients
Williams Medical Group Practice, LLC CurrentSince Jul 1, 2020 Accepting new patients
Williams Medical Group Practice, LLC CurrentSince Jul 1, 2020 Accepting new patients
Jackson County Memorial Hospital Authority Past Accepting new patients

Locations

416 N Main St
Altus, OK 73521
Phone (580) 379-0325

13511 NE 23rd St
Ste 140
Choctaw, OK 73020
Phone (405) 591-3584

220 S Van Buren St
Enid, OK 73703
Phone (580) 234-9355

1201 S Division St
Guthrie, OK 73044
Phone (405) 293-4504

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.

NPI Registry JSON

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

{
    "created_epoch": "1593388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593388800000",
    "number": "1114544871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "890 S SANDPIPER NEST",
            "city": "CHOCTAW",
            "state": "OK",
            "postal_code": "730207012",
            "telephone_number": "405-625-3873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 S DIVISION ST",
            "city": "GUTHRIE",
            "state": "OK",
            "postal_code": "730445021",
            "telephone_number": "405-293-4504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERRIN",
        "first_name": "CANDACE",
        "credential": "APRN-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-29",
        "last_updated": "2020-06-29",
        "certification_date": "2020-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "R0099589",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Guthrie, OK

Sources for this page

Verify at the official NPI Registry.