Individual provider Active NPI

Candice M. Salvas, P.A.

  • Surgical Physician Assistant
  • Manchester, NH
National Provider Identifier
1477897700
Registry record updated Mar 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
0928 Issued in NH
Practice address
718 Smyth Rd
Manchester, NH 03104-7007
Phone
(603) 624-4366
NPI assigned
Nov 27, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 0928 NH Primary

Addresses

Primary practice location

718 Smyth Rd
Manchester, NH 03104-7007

Mailing address

718 Smyth Rd
Manchester, NH 03104-7007
Phone (603) 624-4366

Other practice location 1

One Medical Center Drive
Vascular Surgery
Lebanon, NH 03756-0001
Phone (603) 650-8193

Other names 1

  • Candice Dodge Former name

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
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0928NHMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1353974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646784000000",
    "number": "1477897700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "718 SMYTH RD",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031047007",
            "telephone_number": "603-624-4366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "718 SMYTH RD",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031047007",
            "telephone_number": "603-624-4366"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "One Medical Center Drive",
            "address_2": "Vascular Surgery",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "NH",
            "postal_code": "037560001",
            "country_code": "US",
            "telephone_number": "603-650-8193",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SALVAS",
        "first_name": "CANDICE",
        "middle_name": "M.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-27",
        "last_updated": "2022-03-09",
        "certification_date": "2022-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NH",
            "license": "0928",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CANDICE",
            "last_name": "DODGE",
            "credential": "P.A.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Manchester, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2022; 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.