Individual provider Active NPI

Candace Trippe, PHMNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Suwanee, GA
National Provider Identifier
1295444255
Registry record updated Jun 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN241096 Issued in GA
Practice address
1325 Satellite Blvd NW Ste 400
Suwanee, GA 30024-5299
Phone
(256) 343-9444
NPI assigned
Nov 18, 2022
Last updated
Jun 1, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 1, 2023

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 Registered Nurse 163WP0808X RN241096 GA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RN241096 GA Primary

Addresses

Primary practice location

1325 Satellite Blvd NW Ste 400
Suwanee, GA 30024-5299

Mailing address

1325 Satellite Blvd NW Ste 400
Suwanee, GA 30024-5299
Phone (256) 343-9444

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

44 Professional Dr
Jefferson, GA 30549-6333

PO Box
Suite 1173
Salem, UT 84653

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN241096GAMDPsychiatric/Mental Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1668729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685577600000",
    "number": "1295444255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1325 SATELLITE BLVD NW STE 400",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300245299",
            "telephone_number": "256-343-9444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 SATELLITE BLVD NW STE 400",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300245299",
            "telephone_number": "256-343-9444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRIPPE",
        "first_name": "CANDACE",
        "credential": "PHMNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-11-18",
        "last_updated": "2023-06-01",
        "certification_date": "2023-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "GA",
            "license": "RN241096",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "RN241096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Suwanee, GA

Sources for this page

Verify at the official NPI Registry.