Candace Parker Fleming, PA-C
Individual provider Active NPI Medical Physician Assistant · Columbia, IL
NPI 1184023871 · NPPES record last updated Aug 19, 2014
Key facts
- NPI
- 1184023871
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Medical Physician Assistant 363AM0700X
- Practice address
- 109 W Legion Ave
Columbia, IL 62236-2341 - Phone
- (618) 281-4325
- Fax
- (618) 208-1313
- NPI assigned
- Aug 19, 2014
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20171117001569 | MO | Practitioner - Physician Assistant | 0345506796 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mercy Clinic East Communities | Current |
Accepting new patients | |
| Mercy Clinic East Communities | Past | Accepting new patients | |
| Mercy Hospitals East Communities | Past | Accepting new patients |
Locations
621 S New Ballas Rd
Ste 189A
Saint Louis, MO 63141
Phone (314) 251-6335
621 S New Ballas Rd
Ste 4017B
Saint Louis, MO 63141
Phone (314) 872-9192
851 E 5th St
Ste 328
Washington, MO 63090
Phone (636) 239-1101
16555 Manchester Rd
Ste 201
Wildwood, MO 63040
Phone (636) 458-0040
16555 Manchester Rd
Ste 110
Wildwood, MO 63040
Phone (314) 251-5955
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | Yes |
Addresses
Primary practice location
109 W Legion Ave
Columbia, IL 62236-2341
Mailing address
109 W Legion Ave
Columbia, IL 62236-2341
Phone (618) 281-4325
Other providers in Columbia, IL
- Economy Pharmacy, Inc.
- Audrey Elliott
- ENT & Sleep Medicine Associates LLC
- Chijioke Onyinyechukwu Eseonu
- Family Medicine in Columbia
- Jennifer Flick
- FLS Physical Therapy Associates PC
- Shawn L Forbes
- Erin Marie Frailey
- Dennis Fredrickson
All providers in Columbia, IL · Medical Physician Assistant in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 19, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.