Active NPI
Candace Michelle Nelson, BCABA
- Behavior Analyst
- Bryan, TX
National Provider Identifier
1356862874
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 0-16-7314
- Practice address
- 4001 E 29TH St Ste 190
Bryan, TX 77802-4211 - Phone
- (979) 985-9503
- NPI assigned
- Jul 6, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 0-16-7314 | TX | Primary |
Addresses
Primary practice location
4001 E 29TH St Ste 190
Bryan, TX 77802-4211
Mailing address
3515 Longmire Dr # 256B
College Station, TX 77845-5489
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 47-3705562 | Other | TX | GROUP TAX ID |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1499299200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1499299200000",
"number": "1356862874",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3515 LONGMIRE DR # 256B",
"city": "COLLEGE STATION",
"state": "TX",
"postal_code": "778455489"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4001 E 29TH ST STE 190",
"city": "BRYAN",
"state": "TX",
"postal_code": "778024211",
"telephone_number": "979-985-9503"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NELSON",
"first_name": "CANDACE",
"middle_name": "MICHELLE",
"credential": "BCABA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-07-06",
"last_updated": "2017-07-06",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "TX",
"license": "0-16-7314",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP TAX ID",
"identifier": "47-3705562",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bryan, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.