Individual provider Active NPI

Kandice Haughton, NP

  • Family Nurse Practitioner
  • White Plains, NY
National Provider Identifier
1124721030
Registry record updated May 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
351490 Issued in NY
Practice address
123 E Post Rd
White Plains, NY 10601-5205
Phone
(914) 949-1000
NPI assigned
Mar 22, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2024

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 351490 NY Primary

Addresses

Primary practice location

123 E Post Rd
White Plains, NY 10601-5205

Mailing address

33 Baron Dr
Warwick, NY 10990-3464
Phone (845) 545-6460

Other practice location 1

295 Knollwood Rd
White Plains, NY 10607-1822
Phone (914) 989-7600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20230519001317 NY Practitioner - Nurse Practitioner 1153787981 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

107 W 4TH St
Mount Vernon, NY 10550-4002
Phone 9146997200660

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
351490NYMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Mount Vernon Neighborhood Health Center Inc CurrentSince Oct 20, 2023 Accepting new patients
Mount Vernon Neighborhood Health Center, Inc. CurrentSince Oct 20, 2023 Accepting new patients
Middletown Medical PC CurrentSince Apr 24, 2023 Accepting new patients
Middletown Medical PC CurrentSince Apr 24, 2023 Accepting new patients
Mount Vernon Neighborhood Health Center, Inc. Past Accepting new patients

Locations

111 Maltese Dr
Middletown, NY 10940

107 W 4th St
Mount Vernon, NY 10550
Phone (914) 699-0235

295 Knollwood Rd
White Plains, NY 10607
Phone (914) 699-7200

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.71482

Organizations & group practices 5

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": "1679443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716854400000",
    "number": "1124721030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 BARON DR",
            "city": "WARWICK",
            "state": "NY",
            "postal_code": "109903464",
            "telephone_number": "845-545-6460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 E POST RD",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106015205",
            "telephone_number": "914-949-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "295 Knollwood Rd",
            "address_purpose": "LOCATION",
            "city": "White Plains",
            "state": "NY",
            "postal_code": "106071822",
            "country_code": "US",
            "telephone_number": "914-989-7600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAUGHTON",
        "first_name": "KANDICE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-22",
        "last_updated": "2024-05-28",
        "certification_date": "2024-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "351490",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in White Plains, NY

Sources for this page

Verify at the official NPI Registry.