Individual provider Active NPI

Candace Crittenden

  • Physical Therapist
  • Gainesville, FL
National Provider Identifier
1447934112
Registry record updated Jun 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
30575 Issued in FL
Practice address
3919 Newberry Rd Ste 4
Gainesville, FL 32607-4828
Phone
(352) 373-7984
NPI assigned
Jun 13, 2023
Last updated
Jun 13, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 30575 FL Primary

Addresses

Primary practice location

3919 Newberry Rd Ste 4
Gainesville, FL 32607-4828

Mailing address

7597 SW 87TH Ter
Gainesville, FL 32608-8763
Phone (239) 633-4808

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
30575FLMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Fit for Life Physical Therapy, Inc Physical Therapist PastSince Jun 18, 2023 Accepting new patients
Fit for Life Physical Therapy, Inc Physical Therapist PastSince Jun 18, 2023 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1686614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686614400000",
    "number": "1447934112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7597 SW 87TH TER",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326088763",
            "telephone_number": "239-633-4808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3919 NEWBERRY RD STE 4",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326074828",
            "telephone_number": "352-373-7984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRITTENDEN",
        "first_name": "CANDACE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-13",
        "last_updated": "2023-06-13",
        "certification_date": "2023-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "30575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2023; 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.