Candice Charlene Walllace, CSFA

Primary specialty

Surgical AssistantTaxonomy code 246ZC0007X

Practice address

1035 Red Bud Rd NE
Calhoun, GA 30701-6010

Phone

(706) 602-7800

NPI assigned

Dec 16, 2020

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Interoperability endpoints

• Direct secure messaging: cwallace806345@adventhealth.direct-ci.com

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

{
    "created_epoch": "1608076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608076800000",
    "number": "1407442197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 GWEN DR",
            "city": "RINGGOLD",
            "state": "GA",
            "postal_code": "307366120",
            "telephone_number": "423-762-7603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1035 RED BUD RD NE",
            "city": "CALHOUN",
            "state": "GA",
            "postal_code": "307016010",
            "telephone_number": "706-602-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLLACE",
        "first_name": "CANDICE",
        "middle_name": "CHARLENE",
        "credential": "CSFA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-16",
        "last_updated": "2020-12-16",
        "certification_date": "2020-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "candice.wallace@adventhealth.com",
            "affiliation": "N",
            "endpointDescription": "WORK EMAIL",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "210 Gwen Dr",
            "city": "Ringgold",
            "state": "GA",
            "country_code": "US",
            "postal_code": "307366120",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Michelle Lois Walraven, LCSW
• Staci Coulter Walraven
• Denise Dixon Ward, FNP-BC
• Angela Warlick, MS,CCC-SLP
• David Larkin Weaver, L.P.C.

• Surgical Assistant in Calhoun, GA
• Providers in Calhoun, GA by specialty
• Surgical Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2020; 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.