Individual provider Active NPI

Kandace Williams

  • Psychiatric/Mental Health Nurse Practitioner
  • Marlton, NJ
National Provider Identifier
1235580838
Registry record updated Aug 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
26NJ01180700 Issued in NJ
Practice address
765 Route 70 E BLDG a
Marlton, NJ 08053-2341
Phone
(856) 797-4721
Fax
(856) 797-4785
NPI assigned
Jun 24, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 26NR16031300 NJ
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 26NJ01180700 NJ Primary

Addresses

Primary practice location

765 Route 70 E BLDG a
Marlton, NJ 08053-2341

Mailing address

765 Route 70 E BLDG a
Marlton, NJ 08053-2341
Phone (856) 797-4721

Other practice location 1

770 Woodlane Rd
Westampton, NJ 08060-3804
Phone (609) 267-5928

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL credentialing@cfgpc.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20211006000093 NJ Practitioner - Nurse Practitioner 1850799867 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Center for Family Guidance PCGroup PAC ID 2860396454, 164 clinicians

Practice addresses (Care Compare)

765 Route 70 E
BLDG a
Marlton, NJ 08053-2341
Phone (856) 983-3900

Hospital & facility affiliations

  • Sacred Heart Hospital Hospital, Pensacola, FL, CCN 100025
  • Inspira Medical Center Vineland Hospital, Vineland, NJ, CCN 310032

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
26NR16031300NJMDRegistered Nurse
26NJ01180700NJMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Family Guidance, PC Psychiatric/Mental Health CurrentSince Aug 1, 2021 Accepting new patients

Locations

333 Irving Ave
Bridgeton, NJ 08302
Phone (856) 575-4500

765 Route 70 E
Bldg A
Marlton, NJ 08053
Phone (856) 797-4721

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: kandace.williams.p1@direct.cfg.nextgenshare.com

Organizations & group practices 1

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 2

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

NPI Registry JSON

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

{
    "created_epoch": "1466726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629417600000",
    "number": "1235580838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "765 ROUTE 70 E BLDG A",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080532341",
            "telephone_number": "856-797-4721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "765 ROUTE 70 E BLDG A",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080532341",
            "telephone_number": "856-797-4721",
            "fax_number": "856-797-4785"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "770 Woodlane Rd",
            "address_purpose": "LOCATION",
            "city": "Westampton",
            "state": "NJ",
            "postal_code": "080603804",
            "country_code": "US",
            "telephone_number": "609-267-5928",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "KANDACE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-24",
        "last_updated": "2021-08-20",
        "certification_date": "2021-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NJ",
            "license": "26NR16031300",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ01180700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "credentialing@cfgpc.com",
            "affiliation": "N",
            "address_1": "765 Route 70 E Bldg A",
            "city": "Marlton",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080532341",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Marlton, NJ

Sources for this page

Verify at the official NPI Registry.