Individual provider Active NPI

Candice M Ogle

  • Nurse Practitioner
  • Clinton, TN
National Provider Identifier
1407336548
Registry record updated Jul 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
24425 Issued in TN
Practice address
2681 Andersonville Hwy Ste 102
Clinton, TN 37716-6706
Phone
(865) 494-5960
Fax
(865) 494-5964
NPI assigned
Aug 17, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 24425 TN Primary

Addresses

Primary practice location

2681 Andersonville Hwy Ste 102
Clinton, TN 37716-6706

Mailing address

30 Burton Hills Blvd
Ste 175
Nashville, TN 37215-6403
Phone (615) 988-2014

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20180920002783 TN Practitioner - Nurse Practitioner 1456602077 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Crossroads Urgent Care PLLCGroup PAC ID 8325117484, 181 clinicians

Practice addresses (Care Compare)

6942 Maynardville Pike
Knoxville, TN 37918-5320
Phone (865) 292-6590

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Crossroads Urgent Care PLLC Nurse Practitioner CurrentSince Jul 23, 2021 Accepting new patients
University Health System, Inc Current Accepting new patients
University Health System Inc CurrentSince Jul 10, 2019 Accepting new patients
Crossroads Urgent Care PLLC Nurse Practitioner CurrentSince Jul 23, 2021 Accepting new patients
Ut Urgent Care Centers LLC CurrentSince Dec 3, 2020 Accepting new patients
University Health System, Inc CurrentSince Jul 10, 2019 Accepting new patients

Locations

2681 Andersonville Hwy
Ste 102
Clinton, TN 37716
Phone (865) 494-5960

1928 Alcoa Hwy
Ste B100
Knoxville, TN 37920
Phone (865) 305-6570

2519 Willow Point Way
Knoxville, TN 37931
Phone (865) 694-9349

9625 Kroger Park Dr
Ste 300
Knoxville, TN 37922
Phone (865) 539-2287

6942 Maynardville Pike
Knoxville, TN 37918
Phone (865) 292-6590

524 Market Dr
Lenoir City, TN 37771
Phone (865) 988-0096

525 W Broadway Ave
Maryville, TN 37801
Phone (865) 268-4265

2636 W Andrew Johnson Hwy
Morristown, TN 37814
Phone (423) 200-3225

2445 Memorial Blvd
Ste C
Murfreesboro, TN 37129
Phone (615) 217-6900

30 Burton Hills Blvd
Ste 175
Nashville, TN 37215
Phone (615) 988-2014

1130 Middle Creek Rd
Ste 270
Sevierville, TN 37862
Phone (865) 365-3074

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1534464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627603200000",
    "number": "1407336548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 BURTON HILLS BLVD",
            "address_2": "STE 175",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372156403",
            "telephone_number": "615-988-2014",
            "fax_number": "615-208-1303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2681 ANDERSONVILLE HWY STE 102",
            "city": "CLINTON",
            "state": "TN",
            "postal_code": "377166706",
            "telephone_number": "865-494-5960",
            "fax_number": "865-494-5964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OGLE",
        "first_name": "CANDICE",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-17",
        "last_updated": "2021-07-30",
        "certification_date": "2021-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "24425",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, TN

Sources for this page

Verify at the official NPI Registry.