Individual provider Active NPI

Candace Wilson, APRN

  • Family Nurse Practitioner
  • West Columbia, SC
National Provider Identifier
1417352915
Registry record updated Jun 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
19152 Issued in SC
Practice address
1053 Center Street
SC House Calls Inc
West Columbia, SC 29169
Phone
(800) 491-0909
NPI assigned
Oct 27, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2021

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 19152 SC Primary

Addresses

Primary practice location

1053 Center Street
SC House Calls Inc
West Columbia, SC 29169

Mailing address

1053 Center Street
SC House Calls Inc
West Columbia, SC 29169
Phone (800) 491-0909

Other identifiers 1

IdentifierTypeStateIssuer
NP3413MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20151118002413 SC Practitioner - Nurse Practitioner 3971803222 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
19152SCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Anmed Health CurrentSince Aug 29, 2015 Accepting new patients
Anmed Health Current Accepting new patients
SC House Calls Inc CurrentSince May 4, 2021 Accepting new patients
Anmed Health CurrentSince Aug 29, 2015 Accepting new patients
SC House Calls Inc CurrentSince May 4, 2021 Accepting new patients

Locations

2000 E Greenville St
Anderson, SC 29621
Phone (864) 512-1000

2000 E Greenville St
Fl 3
Anderson, SC 29621
Phone (864) 225-5131

1624 Main St
Columbia, SC 29201
Phone (803) 454-0365

1053 Center St
West Columbia, SC 29169
Phone (803) 454-0365

Organizations & group practices 5

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": "1414368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623715200000",
    "number": "1417352915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1053 CENTER STREET",
            "address_2": "SC HOUSE CALLS INC",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "29169",
            "telephone_number": "800-491-0909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1053 CENTER STREET",
            "address_2": "SC HOUSE CALLS INC",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "29169",
            "telephone_number": "800-491-0909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "CANDACE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-27",
        "last_updated": "2021-06-15",
        "certification_date": "2021-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "19152",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP3413",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Columbia, SC

Sources for this page

Verify at the official NPI Registry.