Candice Marie Bazemore, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C005845 Issued in NC

Practice address

6809 Fairview Rd
Charlotte, NC 28210-3336

Phone

(704) 365-7777

Fax

(704) 365-9256

NPI assigned

Feb 5, 2007

Last updated

Feb 7, 2008By 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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Aug 15, 2017 through Aug 15, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202342400000",
    "number": "1467591842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6809 FAIRVIEW RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282103336",
            "telephone_number": "704-365-7777",
            "fax_number": "704-365-9256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6809 FAIRVIEW RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282103336",
            "telephone_number": "704-365-7777",
            "fax_number": "704-365-9256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAZEMORE",
        "first_name": "CANDICE",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-05",
        "last_updated": "2008-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C005845",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCSW",
            "identifier": "C005845",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexis Bayiha
• Bruce C Bayles, DO
• Jake Hamilton Bayless, DO
• Leigh Christine Baylor, DO
• Amanda Bazemore, AGNP
• Imani Bazemore, MD
• Sarah Rebecca Bazzle, LMBT
• BCC Home Care Services
• BCH Counseling & Consultation Services
• BCJ Associates LLC

• Clinical Social Worker in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2008; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.