Individual provider Active NPI

Candace Estee Hercules, MS CCC SLP, CDP

  • Speech-Language Pathologist
  • Alexandria, VA
National Provider Identifier
1225710494
Registry record updated Aug 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2202010986 Issued in VA
Practice address
5550 Cardinal PL
Alexandria, VA 22304-8716
Phone
(703) 940-3300
NPI assigned
Aug 7, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X 2202010986 VA Primary

Addresses

Primary practice location

5550 Cardinal PL
Alexandria, VA 22304-8716

Mailing address

253 Taft CT Apt B8
Battle Creek, MI 49014-4458
Phone (347) 737-6818

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230901001808 VA Practitioner - Qualified Speech Language Pathologist 3577926989 Reassigns benefits to 2 organizations
I20230904000110 DC Practitioner - Qualified Speech Language Pathologist 3577926989 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Comprehensive Therapeutics LTDGroup PAC ID 8921230137, 324 clinicians

Practice addresses (Care Compare)

8315 Turning Leaf LN
MC Lean, VA 22102-2615
Phone (571) 662-5825

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Healthcare Services, Inc Speech-Language Pathologist Current Accepting new patients
Legacy Healthcare Services Inc Speech-Language Pathologist CurrentSince Sep 11, 2023 Accepting new patients
Legacy Healthcare Services, Inc. Speech-Language Pathologist CurrentSince Sep 11, 2023 Accepting new patients
Comprehensive Therapeutics LTD Single Specialty CurrentSince Jul 19, 2023 Accepting new patients
Legacy Healthcare Services Inc Speech-Language Pathologist CurrentSince Sep 11, 2023 Accepting new patients
Comprehensive Therapeutics LTD Single Specialty CurrentSince Jul 19, 2023 Accepting new patients

Locations

110 Horizon Dr
#310
Raleigh, NC 27615

110 Horizon Dr
Ste 310
Raleigh, NC 27615
Phone (970) 215-3300

10286 Brook Rd
Glen Allen, VA 23059
Phone (571) 200-6617

3365 Ogden Rd
Roanoke, VA 24018
Phone (540) 682-7500

Organizations & group practices 6

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": "1691366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691366400000",
    "number": "1225710494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "253 TAFT CT APT B8",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "490144458",
            "telephone_number": "347-737-6818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5550 CARDINAL PL",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223048716",
            "telephone_number": "703-940-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERCULES",
        "first_name": "CANDACE",
        "middle_name": "ESTEE",
        "name_prefix": "Ms.",
        "credential": "MS CCC SLP, CDP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-07",
        "last_updated": "2023-08-07",
        "certification_date": "2023-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2202010986",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.