Individual provider Active NPI

Candice Marie Midkiff, FNP-C

  • Family Nurse Practitioner
  • Bossier City, LA
National Provider Identifier
1154054492
Registry record updated Jul 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
226511 Issued in LA
Practice address
2539 Viking Dr Ste 100
Bossier City, LA 71111-1611
Phone
(318) 747-8105
Fax
(318) 747-8150
NPI assigned
Jul 5, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2022

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 226511 LA Primary

Addresses

Primary practice location

2539 Viking Dr Ste 100
Bossier City, LA 71111-1611

Mailing address

2539 Viking Dr Ste 101
Bossier City, LA 71111-2165
Phone (318) 747-8100

Other practice location 1

2539 Viking Dr Ste 101
Bossier City, LA 71111-2165
Phone (318) 747-8100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20220905000094 LA Practitioner - Nurse Practitioner 8729462049 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bossier Family Medicine, LLCGroup PAC ID 1850318122, 21 clinicians

Practice addresses (Care Compare)

160 Stone Creek Rd
Stonewall, LA 71078-4906

2539 Viking Dr
Bossier City, LA 71111-2165

5390 Barksdale Blvd
Bossier City, LA 71112-4526
Phone (318) 747-8100

Hospital & facility affiliations

  • Christus Shreveport-Bossier Health System Hospital, Shreveport, LA, CCN 190041

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
226511LAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bossier Family Medicine, LLC CurrentSince Jul 17, 2022 Accepting new patients
Bossier Family Medicine, LLC CurrentSince Aug 1, 2022 Accepting new patients

Locations

2539 Viking Dr
Ste 101
Bossier City, LA 71111
Phone (318) 747-8100

2539 Viking Dr
Bossier City, LA 71111
Phone (318) 741-2920

5390 Barksdale Blvd
Ste 100
Bossier City, LA 71112
Phone (318) 747-8100

5390 Barksdale Blvd
Ste 200
Bossier City, LA 71112
Phone (318) 747-8100

2539 Viking Dr
Ste 100
Bossier City, LA 71111
Phone (318) 747-8100

160 Stone Creek Rd
Ste A
Stonewall, LA 71078
Phone (318) 925-3339

160 Stone Creek Rd
Ste B
Stonewall, LA 71078
Phone (318) 925-3338

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IGAJAA

Organizations & group practices 2

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": "1656979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657670400000",
    "number": "1154054492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2539 VIKING DR STE 101",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711112165",
            "telephone_number": "318-747-8100",
            "fax_number": "318-747-8150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2539 VIKING DR STE 100",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711111611",
            "telephone_number": "318-747-8105",
            "fax_number": "318-747-8150"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2539 Viking Dr Ste 101",
            "address_purpose": "LOCATION",
            "city": "Bossier City",
            "state": "LA",
            "postal_code": "711112165",
            "country_code": "US",
            "telephone_number": "318-747-8100",
            "fax_number": "318-747-8150",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIDKIFF",
        "first_name": "CANDICE",
        "middle_name": "MARIE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-05",
        "last_updated": "2022-07-13",
        "certification_date": "2022-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "226511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bossier City, LA

Sources for this page

Verify at the official NPI Registry.