Candace Worsham, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

21172 Issued in MS

Practice address

1924 30TH Ave
Gulfport, MS 39501-4534

Phone

(228) 863-7117

NPI assigned

Jul 11, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

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.

• St Francis Medical Center, Inc

  • Rehabilitation Hospital Unit
  • Monroe, LA
  • NPI 1013906239
  NPD (past)

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

{
    "created_epoch": "1184112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280880000000",
    "number": "1295934115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1924 30TH AVE",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395014534",
            "telephone_number": "228-863-7117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1924 30TH AVE",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395014534",
            "telephone_number": "228-863-7117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WORSHAM",
        "first_name": "CANDACE",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-11",
        "last_updated": "2010-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "21172",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda R Woodcock, CNP
• Thai Thao Woodcock, CSFA
• Jillian N Woodland, LCSW
• Amanda Woodruff, MS, RD, LD
• Danelle Woods, PCMHT
• Grace Elizabeth Worth
• Wright and Associates Medical Logistics LLC
• Shawn X Wu, MD
• Marsha Wyatt, LMT
• Valerie Wyatt

• Family Medicine Physician in Gulfport, MS
• Providers in Gulfport, MS by specialty
• Family Medicine Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.