Individual provider Active NPI

Candace M Caputo, RN, CDE

  • Diabetes Educator Registered Nurse
  • Southbridge, MA
National Provider Identifier
1174851356
Registry record updated Nov 25, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diabetes Educator Registered NurseTaxonomy code 163WD0400X
License
223997 Issued in MA
Practice address
100 South St
Harrington Hospital
Southbridge, MA 01550-4051
Phone
(508) 765-2294
Fax
(508) 764-2475
NPI assigned
Nov 25, 2009
Last updated
Nov 25, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diabetes Educator Registered Nurse 163WD0400X 223997 MA Primary

Addresses

Primary practice location

100 South St
Harrington Hospital
Southbridge, MA 01550-4051

Mailing address

100 South Street
Harrington Hospital
Southbridge, MA 01550
Phone (508) 765-2294

Other identifiers 2

IdentifierTypeStateIssuer
223997OtherMAREGISTERED NURSE
2071-0344OtherMACERTIFIED DIABETES EDUCATOR

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
223997MAMDDiabetes Educator Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1259107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259107200000",
    "number": "1174851356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 SOUTH STREET",
            "address_2": "HARRINGTON HOSPITAL",
            "city": "SOUTHBRIDGE",
            "state": "MA",
            "postal_code": "01550",
            "telephone_number": "508-765-2294",
            "fax_number": "508-764-2475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 SOUTH ST",
            "address_2": "HARRINGTON HOSPITAL",
            "city": "SOUTHBRIDGE",
            "state": "MA",
            "postal_code": "015504051",
            "telephone_number": "508-765-2294",
            "fax_number": "508-764-2475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAPUTO",
        "first_name": "CANDACE",
        "middle_name": "M",
        "credential": "RN, CDE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-25",
        "last_updated": "2009-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WD0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "MA",
            "license": "223997",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERED NURSE",
            "identifier": "223997",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CERTIFIED DIABETES EDUCATOR",
            "identifier": "2071-0344",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Southbridge, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2009; 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.