Candace Churchwell Petree, PNP-C

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

00300347 Issued in NC

Practice address

705 Summit Crossing PL
Gastonia, NC 28054-2216

Phone

(704) 671-6300

Fax

(704) 671-6307

NPI assigned

Sep 29, 2005

Sex

Female

Sole proprietor

No

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

Enrolled in NC

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Caromont Medical Group Inc

  • Family Medicine Physician
  • Gastonia, NC
  • NPI 1356314272
  Medicare reassignment NPD
• Caromont Medical Group Inc

  • Family Medicine Physician
  • Stanley, NC
  • NPI 1972301380
  NPD
• Caromont Medical Group, Inc.

  • Pediatrics Physician
  • Gastonia, NC
  • NPI 1194904706
  NPD

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

{
    "created_epoch": "1127952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285027200000",
    "number": "1326035049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 SUMMIT CROSSING PL",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280542216",
            "telephone_number": "704-671-6300",
            "fax_number": "704-671-6307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 SUMMIT CROSSING PL",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280542216",
            "telephone_number": "704-671-6300",
            "fax_number": "704-671-6307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETREE",
        "first_name": "CANDACE",
        "middle_name": "CHURCHWELL",
        "credential": "PNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-29",
        "last_updated": "2010-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NC",
            "license": "00300347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elijah Perry
• Zharyia Shanise Perry, MSW, LCSWA
• Mariana L Pesantez, MS, OTR/L
• Emmeleia Peterson
• Thewanda Anise Peterson, CRNA
• Caleb Timothy Pflederer, MD
• Alex H D Pham, DDS
• Alyssa Phifer
• Anitra Nash Phifer
• Emily Teague Philbeck, FNP

• Pediatric Nurse Practitioner in Gastonia, NC
• Providers in Gastonia, NC by specialty
• Pediatric Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.