Individual provider Active NPI

Candi Holyfield, FNP-C

  • Nurse Practitioner
  • Marietta, GA
National Provider Identifier
1477020295
Registry record updated Oct 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN196832 Issued in GA
Practice address
1395 S Marietta Pkwy SE Ste 216
Marietta, GA 30067-7832
Phone
(770) 688-1090
NPI assigned
Oct 30, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN196832 GA Primary

Addresses

Primary practice location

1395 S Marietta Pkwy SE Ste 216
Marietta, GA 30067-7832

Mailing address

5040 Cinnabar Dr
Alpharetta, GA 30022-7922
Phone (404) 644-0045

Other identifiers 1

IdentifierTypeStateIssuer
RN196832OtherGAGA RN LICENSE

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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1540857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540857600000",
    "number": "1477020295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5040 CINNABAR DR",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300227922",
            "telephone_number": "404-644-0045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1395 S MARIETTA PKWY SE STE 216",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300677832",
            "telephone_number": "770-688-1090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLYFIELD",
        "first_name": "CANDI",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-30",
        "last_updated": "2018-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN196832",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GA RN LICENSE",
            "identifier": "RN196832",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2018; 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.