Individual provider Active NPI

Candia S Gaumer, RN

  • Medical-Surgical Registered Nurse
  • Monticello, IN
National Provider Identifier
1114741584
Registry record updated Nov 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical-Surgical Registered NurseTaxonomy code 163WM0705X
License
28274933A Issued in IN
Practice address
720 S 6TH St
Monticello, IN 47960-8182
Phone
(574) 583-7111
NPI assigned
Nov 13, 2024
Last updated
Nov 13, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical-Surgical Registered Nurse 163WM0705X 28274933A IN Primary

Addresses

Primary practice location

720 S 6TH St
Monticello, IN 47960-8182

Mailing address

6841 W Canal St
Logansport, IN 46947-7250
Phone (765) 210-8838

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
Registered Nurse

State licenses

LicenseStateTypeSpecialty
28274933AINMDMedical-Surgical Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1731456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731456000000",
    "number": "1114741584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6841 W CANAL ST",
            "city": "LOGANSPORT",
            "state": "IN",
            "postal_code": "469477250",
            "telephone_number": "765-210-8838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 S 6TH ST",
            "city": "MONTICELLO",
            "state": "IN",
            "postal_code": "479608182",
            "telephone_number": "574-583-7111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAUMER",
        "first_name": "CANDIA",
        "middle_name": "S",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-11-13",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "IN",
            "license": "28274933A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monticello, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.