Candace Martina Hack, APRN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

3015668 Issued in KY

Practice address

11 McLeod LN
Madisonville, KY 42431-3650

Phone

(270) 245-2413

Fax

(877) 302-0536

NPI assigned

Jan 18, 2021

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 KY

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

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Pathway Mental Health

  • Psychiatric/Mental Health Nurse Practitioner
  • Madisonville, KY
  • NPI 1982378436
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1610928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724889600000",
    "number": "1407445059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 MCLEOD LN",
            "city": "MADISONVILLE",
            "state": "KY",
            "postal_code": "424313650",
            "telephone_number": "270-245-2413",
            "fax_number": "877-302-0636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 MCLEOD LN",
            "city": "MADISONVILLE",
            "state": "KY",
            "postal_code": "424313650",
            "telephone_number": "270-245-2413",
            "fax_number": "877-302-0536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HACK",
        "first_name": "CANDACE",
        "middle_name": "MARTINA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-18",
        "last_updated": "2024-08-29",
        "certification_date": "2024-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KY",
            "license": "3015668",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie Marie Guess, APRN
• Guynn Developmental Intervention
• Robin Guynn
• James Greg Haag, DMD
• John Haastrup, M.D.
• Tracy R Hagan, AOCNP
• Amanda Marie Halcomb, OTR/L
• Jason Haley
• Brittany Hall, RDN, CDE
• Jared Hall, APRN

• Psychiatric/Mental Health Nurse Practitioner in Madisonville, KY
• Providers in Madisonville, KY by specialty
• Psychiatric/Mental Health Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.