Individual provider Active NPI

Candice Ogline, RN, APN,C

  • Adult Health Nurse Practitioner
  • Pennsauken, NJ
National Provider Identifier
1295792331
Registry record updated Mar 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
26NJ00039200 Issued in NJ
Practice address
2475 McClellan Ave
Pennsauken, NJ 08109-4683
Phone
(856) 675-3660
Fax
(856) 675-3659
NPI assigned
May 1, 2006
Last updated
Mar 15, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 26NJ00039200 NJ Primary

Addresses

Primary practice location

2475 McClellan Ave
Pennsauken, NJ 08109-4683

Mailing address

2475 McClellan Ave
Life at Lourdes
Pennsauken, NJ 08109
Phone (856) 675-3660

Other identifiers 1

IdentifierTypeStateIssuer
0029475MedicaidNJ

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
I20040622000535 NJ Practitioner - Nurse Practitioner 9739164914 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Personal NP Services LLCGroup PAC ID 9335455179, 65 clinicians

Practice addresses (Care Compare)

456 Chestnut St
Suite 102
Lakewood, NJ 08701-6124
Phone (732) 486-7373

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NJ00039200NJMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Provider Partners Care Management LP CurrentSince Jul 1, 2025 Accepting new patients
HCR Manorcare Medical Services of Florida LLC CurrentSince Jul 31, 2014 Accepting new patients
Personal NP Services, LLC CurrentSince Feb 1, 2025 Accepting new patients
Vitality NP Group LLC Adult Health PastSince Feb 1, 2025 Accepting new patients
Life at Lourdes Inc Past Accepting new patients

Locations

8820 Columbia 100 Pkwy
Ste 430
Columbia, MD 21045
Phone (410) 967-2097

1412 Marlton Pike E
Cherry Hill, NJ 08034
Phone (856) 428-1600

456 Chestnut St
Ste 102
Lakewood, NJ 08701
Phone (732) 282-7200

685 River Ave
Unit 3
Lakewood, NJ 08701
Phone (732) 987-3855

170 Changebridge Rd
Bldg C3
Montville, NJ 07045
Phone (973) 575-5540

L2540
Columbus, OH 43260

333 N Summit St
Fl 7
Toledo, OH 43604
Phone (419) 252-5909

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1146441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331769600000",
    "number": "1295792331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2475 MCCLELLAN AVE",
            "address_2": "LIFE AT LOURDES",
            "city": "PENNSAUKEN",
            "state": "NJ",
            "postal_code": "08109",
            "telephone_number": "856-675-3660",
            "fax_number": "856-675-3659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2475 MCCLELLAN AVE",
            "city": "PENNSAUKEN",
            "state": "NJ",
            "postal_code": "081094683",
            "telephone_number": "856-675-3660",
            "fax_number": "856-675-3659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OGLINE",
        "first_name": "CANDICE",
        "credential": "RN, APN,C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-01",
        "last_updated": "2012-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NJ",
            "license": "26NJ00039200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0029475",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pennsauken, NJ

Sources for this page

Verify at the official NPI Registry.