NPIMap

Individual provider Active NPI

Candace Wooten

  • Family Medicine Physician
  • New Albany, IN
National Provider Identifier
1174941801
Registry record updated Mar 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01078503A Issued in IN
Practice address
4101 Technology Ave
New Albany, IN 47150-8548
Phone
(812) 941-4500
NPI assigned
Mar 31, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 01078503A IN Primary

Addresses

Primary practice location

4101 Technology Ave
New Albany, IN 47150-8548

Mailing address

4101 Technology Ave
New Albany, IN 47150-8548
Phone (812) 941-4500

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address candace.wootenmd.p63@direct.ahni.nextgenshare.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170816001224 IN Practitioner - Family Practice 4688960354 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
New Horizons Physical Therapy Limited PartnershipGroup PAC ID 4183641608, 77 clinicians

Practice addresses (Care Compare)

10995 Allisonville Rd
Suite 100
Fishers, IN 46038-2616
Phone (317) 842-7928

2125 State St
New Albany, IN 47150-4972

4101 Technology Ave
New Albany, IN 47150-8548
Phone (812) 941-4500

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01078503AINMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
American Health Network of Indiana, LLC Single Specialty CurrentSince Aug 1, 2017 Accepting new patients
American Health Network of Indiana LLC Single Specialty CurrentSince Aug 1, 2017 Accepting new patients
American Health Network of Indiana, LLC Family Medicine Past Accepting new patients

Locations

10995 Allisonville Rd
Ste 100
Fishers, IN 46038
Phone (317) 842-7928

7440 Woodland Dr
Indianapolis, IN 46278
Phone (317) 450-3357

2857 Charlestown Rd
Ste 100
New Albany, IN 47150
Phone (812) 944-7500

2585 Charlestown Rd
New Albany, IN 47150
Phone (812) 944-8451

4101 Technology Ave
New Albany, IN 47150
Phone (812) 941-4500

Interoperability endpoints

  • Direct secure messaging: cwooten211427@direct.optum.com

Organizations & group practices 4

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 28

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1396224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616976000000",
    "number": "1174941801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4101 TECHNOLOGY AVE",
            "city": "NEW ALBANY",
            "state": "IN",
            "postal_code": "471508548",
            "telephone_number": "812-941-4500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4101 TECHNOLOGY AVE",
            "city": "NEW ALBANY",
            "state": "IN",
            "postal_code": "471508548",
            "telephone_number": "812-941-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOTEN",
        "first_name": "CANDACE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-03-31",
        "last_updated": "2021-03-29",
        "certification_date": "2021-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01078503A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "candace.wootenmd.p63@direct.ahni.nextgenshare.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "4101 Technology Ave",
            "city": "New Albany",
            "state": "IN",
            "country_code": "US",
            "postal_code": "471508548",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in New Albany, IN

Sources for this page

Verify at the official NPI Registry.