Individual provider Active NPI

Candice Pollard-Reed, CRNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Ashtabula, OH
National Provider Identifier
1205378346
Registry record updated Aug 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN.CNP.021490 Issued in OH
Practice address
4726 Main Ave
Ashtabula, OH 44004-6929
Phone
(440) 992-8552
NPI assigned
Nov 7, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 10, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN.CNP.021490 OH Primary
Psychiatric/Mental Health Registered Nurse 163WP0808X RN.383104 OH

Addresses

Primary practice location

4726 Main Ave
Ashtabula, OH 44004-6929

Mailing address

4726 Main Ave
Ashtabula, OH 44004-6929
Phone (440) 992-8552

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20190802000787 OH Practitioner - Nurse Practitioner 8921334616 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prosser Public Hospital District of Benton CountyGroup PAC ID 6709787872, shared by 5 NPIs, 111 clinicians

Practice addresses (Care Compare)

701 Dale Ave
Benton City, WA 99320-5250
Phone (509) 588-4075

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN.383104OHMDPsychiatric/Mental Health Registered Nurse
APRN.CNP.021490OHMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Signature Health Inc CurrentSince Jun 23, 2019 Accepting new patients
Signature Health, Inc. Current Accepting new patients
Signature Health, Inc CurrentSince Jun 23, 2019 Accepting new patients

Locations

4726 Main Ave
Ashtabula, OH 44004
Phone (440) 992-8552

21100 Southgate Park Blvd
Maple Heights, OH 44137
Phone (216) 663-6100

7232 Justin Way
Mentor, OH 44060
Phone (440) 488-2855

38882 Mentor Ave
Willoughby, OH 44094

Interoperability endpoints

  • Direct secure messaging: cpollardreed327676@direct.ochin.org

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1478476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1502323200000",
    "number": "1205378346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4726 MAIN AVE",
            "city": "ASHTABULA",
            "state": "OH",
            "postal_code": "440046929",
            "telephone_number": "440-992-8552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4726 MAIN AVE",
            "city": "ASHTABULA",
            "state": "OH",
            "postal_code": "440046929",
            "telephone_number": "440-992-8552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLLARD-REED",
        "first_name": "CANDICE",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-11-07",
        "last_updated": "2017-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "APRN.CNP.021490",
            "primary": true
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "OH",
            "license": "RN.383104",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ashtabula, OH

Sources for this page

Verify at the official NPI Registry.