Individual provider Active NPI

Candace D Edick, FNP

  • Family Nurse Practitioner
  • Leonardtown, MD
National Provider Identifier
1396441523
Registry record updated Mar 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R182468 Issued in MD
Practice address
41680 Miss Bessie Dr Ste 102
Leonardtown, MD 20650-2963
Phone
(301) 997-1788
NPI assigned
Jan 31, 2023
Last updated
Mar 23, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R182468 MD Primary

Addresses

Primary practice location

41680 Miss Bessie Dr Ste 102
Leonardtown, MD 20650-2963

Mailing address

41680 Miss Bessie Dr Ste 102
Leonardtown, MD 20650-2963
Phone (301) 997-1788

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20230525003297 MD Practitioner - Nurse Practitioner 4981060464 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medstar Medical Group II LLCGroup PAC ID 0547413825, 3,726 clinicians

Practice addresses (Care Compare)

29955 Three Notch Rd
100 MMG at Charlotte Hall
Charlotte Hall, MD 20622-3159
Phone (301) 290-5300

41680 Miss Bessie Dr
Leonardtown, MD 20650-2906
Phone (301) 997-0055

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.34 of 100Reported as group
Quality
67.9
Promoting interoperability
100
Improvement activities
40
Cost
69.47

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R182468MDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Medstar Medical Group II LLC CurrentSince Apr 15, 2023 Accepting new patients
Southern Maryland Women's Healthcare, PA CurrentSince Feb 8, 2023 Accepting new patients
Medstar Medical Group II LLC Past Accepting new patients

Locations

3007 Tilden St NW
Ste 5N
Washington, DC 20008

29955 Three Notch Rd
Ste 100
Charlotte Hall, MD 20622
Phone (301) 290-5300

41680 Miss Bessie Dr
Ste 102
Leonardtown, MD 20650
Phone (301) 997-1788

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1675123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679529600000",
    "number": "1396441523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41680 MISS BESSIE DR STE 102",
            "city": "LEONARDTOWN",
            "state": "MD",
            "postal_code": "206502963",
            "telephone_number": "301-997-1788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41680 MISS BESSIE DR STE 102",
            "city": "LEONARDTOWN",
            "state": "MD",
            "postal_code": "206502963",
            "telephone_number": "301-997-1788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDICK",
        "first_name": "CANDACE",
        "middle_name": "D",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-31",
        "last_updated": "2023-03-23",
        "certification_date": "2023-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R182468",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leonardtown, MD

Sources for this page

Verify at the official NPI Registry.