Candace D Mangum, CRNP

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

1-090975 Issued in AL

Practice address

56 West Main Street
Notasulga, AL 36866-0100

Phone

(334) 257-1081

Fax

(334) 257-1086

NPI assigned

Dec 1, 2006

Last updated

Jun 8, 2009By the provider in NPPES

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

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in AL

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, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Community Hospital IncGroup PAC ID 2062408487, 15 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• The East Alabama Healthcare Authority Hospital, Opelika, AL, CCN 010029
• Community Hospital Inc Hospital, Tallassee, AL, CCN 010034

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-usa.unify.chbase.com/org/commal-d9d80e4d

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.

• Community Hospital Inc

  dba Tallassee Internal Medicine

  • Internal Medicine Physician
  • Tallassee, AL
  • NPI 1295040376
  Medicare reassignment Care Compare group NPD
• Community Hospital Inc

  • Rural Acute Care Hospital
  • Tallassee, AL
  • NPI 1730120726
  NPD
• Community Hospital Inc

  dba Tuskegee Medical and Surgical Clinic

  • Family Medicine Physician
  • Tuskegee, AL
  • NPI 1922135425
  NPD
• Community Hospital

  • General Acute Care Hospital
  • Tallassee, AL
  • NPI 1447218235
  NPD (past)
• Notasulga Healthcare

  dba Community Hospital

  • Primary Care Nurse Practitioner
  • Notasulga, AL
  • NPI 1164550489
  NPD (past)

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

• Community Hospital Inc

  • Rural Acute Care Hospital
  • Tallassee, AL
  • NPI 1730120726
  Care Compare affiliation
• The East Alabama Health Care Authority

  dba East Alabama Medical Center

  • General Acute Care Hospital
  • Opelika, AL
  • NPI 1154386431
  Care Compare affiliation

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1244419200000",
    "number": "1407924384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100",
            "city": "NOTASULGA",
            "state": "AL",
            "postal_code": "368660100",
            "telephone_number": "334-257-1081",
            "fax_number": "334-257-1086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "56 WEST MAIN STREET",
            "city": "NOTASULGA",
            "state": "AL",
            "postal_code": "368660100",
            "telephone_number": "334-257-1081",
            "fax_number": "334-257-1086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANGUM",
        "first_name": "CANDACE",
        "middle_name": "D",
        "name_prefix": "Ms.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-01",
        "last_updated": "2009-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "AL",
            "license": "1-090975",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ORGANIZATIONAL NPI",
            "identifier": "1164550489",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891017112",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "051558482",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lula Bridges, LBSW, SAP, CCAP
• Corrective Bodyworks, LLC (Corrective BodyWorks Rehabilitation and Wellness)
• Brenna Cosby, LICENSED SOCIAL WORK
• Encore Rehabilitation, Inc. (Encore Rehab of Reeltown)
• Christopher Alexander Layfield
• Notasulga Healthcare (Community Hospital)
• Dorothy Ross, M.D.
• Rodney C Teague, PHD
• James Williams Jr., PH.D.
• Keena Marquett Wilson

• Primary Care Nurse Practitioner in Notasulga, AL
• Providers in Notasulga, AL by specialty
• Primary Care Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2009; 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.