Individual provider Active NPI

Candice Latrice Reynolds, PMHNP-BC, FNP-C

  • Family Nurse Practitioner
  • Dover, DE
National Provider Identifier
1457664104
Registry record updated Apr 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
LG-0000531 Issued in DE
Practice address
1418 S State St
Dover, DE 19901-4948
Phone
(302) 257-3135
Fax
(302) 526-2410
NPI assigned
Jul 23, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2025

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AC005517 MD
Family Nurse Practitioner 363LF0000X APRN9486111 FL
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN9486111 FL
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AC005680 MD
Psychiatric/Mental Health Nurse Practitioner 363LP0808X L8-0010481 DE
Family Nurse Practitioner 363LF0000X LG-0000531 DE Primary

Addresses

Primary practice location

1418 S State St
Dover, DE 19901-4948

Mailing address

2139 N University Dr
PMB 3000
Coral Springs, FL 33071-6134
Phone (302) 399-3019

Other practice location 1

7901 4th St N Ste 300
St Petersburg, FL 33702-4399
Phone (302) 648-2776

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE, FL, TX, MA, DC5 enrollments
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 5

Enrollment IDStateProvider typePAC IDDetails
I20110610000043 DE Practitioner - Nurse Practitioner 0143407650 Reassigns benefits to 3 organizations
I20190712000700 FL Practitioner - Nurse Practitioner 0143407650 Reassigns benefits to 2 organizations
I20221126000008 TX Practitioner - Nurse Practitioner 0143407650 Reassigns benefits to 1 organization
I20221208000653 MA Practitioner - Nurse Practitioner 0143407650 Reassigns benefits to 1 organization
I20250226001651 DC Practitioner - Nurse Practitioner 0143407650 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Northnode Group CounselingGroup PAC ID 1254753114, 2 clinicians
Grow Healthcare Group PAGroup PAC ID 3476961368, 1,045 clinicians

Practice addresses (Care Compare)

1418 S State St
Dover, DE 19901-4948
Phone (302) 257-3135

66 E Flagler St
Miami, FL 33130-1807
Phone (786) 244-7711

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
LG-0000531DEMDFamily Nurse Practitioner
AC005517MDMDFamily Nurse Practitioner
L8-0010481DEMDPsychiatric/Mental Health Nurse Practitioner
AC005680MDMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Psychiatric/Mental Health CurrentSince Jan 28, 2025 Accepting new patients
Northnode Group Counseling CurrentSince Mar 28, 2022 Accepting new patients
Carbon Health Medical Group of Florida PA CurrentSince Apr 1, 2023 Accepting new patients
Carbon Health Medical Group of Florida PA CurrentSince Aug 13, 2022 Accepting new patients
Westside Family Healthcare, Inc CurrentSince Apr 6, 2011 Accepting new patients
Westside Family Healthcare, Inc. Current Accepting new patients

Locations

2920 Telegraph Ave
Ste 100
Berkeley, CA 94705
Phone (415) 549-0212

1609 S State St
Dover, DE 19901
Phone (302) 257-3135

1418 S State St
Dover, DE 19901
Phone (302) 257-3135

200 Continental Dr
Ste 401
Newark, DE 19713
Phone (302) 238-6200

1802 W 4th St
Wilmington, DE 19805
Phone (302) 655-5576

4825 SW 148th Ave
Davie, FL 33330
Phone (954) 526-7291

915 W 49th St
Hialeah, FL 33012
Phone (305) 200-1225

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

100 Cambridge St
Fl 14
Boston, MA 02114
Phone (617) 917-2389

17903 W Lake Houston Pkwy
Ste 101
Humble, TX 77346
Phone (215) 570-6856

8300 Boone Blvd
Ste 500
Vienna, VA 22182
Phone (703) 884-2598

Organizations & group practices 6

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": "1279843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744588800000",
    "number": "1457664104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2139 N UNIVERSITY DR",
            "address_2": "PMB 3000",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330716134",
            "telephone_number": "302-399-3019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1418 S STATE ST",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199014948",
            "telephone_number": "302-257-3135",
            "fax_number": "302-526-2410"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7901 4th St N Ste 300",
            "address_purpose": "LOCATION",
            "city": "St Petersburg",
            "state": "FL",
            "postal_code": "337024399",
            "country_code": "US",
            "telephone_number": "302-648-2776",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "CANDICE",
        "middle_name": "LATRICE",
        "credential": "PMHNP-BC, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-23",
        "last_updated": "2025-04-14",
        "certification_date": "2025-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "AC005517",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN9486111",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN9486111",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "AC005680",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "DE",
            "license": "L8-0010481",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "DE",
            "license": "LG-0000531",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dover, DE

Sources for this page

Verify at the official NPI Registry.