Individual provider Active NPI

Candace A Chapuseaux, A.R.N.P.

  • Adult Health Nurse Practitioner
  • Leesburg, FL
National Provider Identifier
1174517510
Registry record updated Jan 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
ARNP 9223166 Issued in FL
Practice address
511 Medical Plaza Dr
Suite 101
Leesburg, FL 34748-7326
Phone
(352) 728-6808
Fax
(352) 728-3637
NPI assigned
Aug 31, 2005
Last updated
Jan 29, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X ARNP 9223166 FL Primary

Addresses

Primary practice location

511 Medical Plaza Dr
Suite 101
Leesburg, FL 34748-7326

Mailing address

511 Medical Plaza Dr
Suite 101
Leesburg, FL 34748-7326
Phone (352) 728-6808

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20050615000643 FL Practitioner - Nurse Practitioner 7113961608 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Legacy Healthcare Services IncGroup PAC ID 2163339722, shared by 46 NPIs, 3,431 clinicians
Lowell F. Clark MD PAGroup PAC ID 7416918370, 31 clinicians

Practice addresses (Care Compare)

1550 Killingsworth Way
The Villages, FL 32162-2175
Phone (352) 633-2971

212 S Florida St
Bushnell, FL 33513-6703
Phone (352) 793-2441

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ARNP 9223166FLMDAdult Health Nurse Practitioner

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1125446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264723200000",
    "number": "1174517510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 MEDICAL PLAZA DR",
            "address_2": "SUITE 101",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347487326",
            "telephone_number": "352-728-6808",
            "fax_number": "352-728-3637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 MEDICAL PLAZA DR",
            "address_2": "SUITE 101",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347487326",
            "telephone_number": "352-728-6808",
            "fax_number": "352-728-3637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAPUSEAUX",
        "first_name": "CANDACE",
        "middle_name": "A",
        "credential": "A.R.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-31",
        "last_updated": "2010-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "ARNP 9223166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, FL

Sources for this page

Verify at the official NPI Registry.