Organization Active NPI

Candace Y Covington MD

  • Surgery Physician
  • Mineral Wells, TX
National Provider Identifier
1497099279
Registry record updated Mar 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
N3581 Issued in TX
Legal business name
CANDACE Y COVINGTON MD
Practice address
218 SW 26TH Ave
Suite D
Mineral Wells, TX 76067-8251
Phone
(940) 325-4925
Fax
(940) 325-4955
NPI assigned
Nov 19, 2012
Last updated
Mar 28, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2013

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

Authorized official

Name
Dr. Candace Y Covington, MDNPI 1295964757
Title
Owner
Phone
(940) 325-4925

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X N3581 TX Primary

Addresses

Primary practice location

218 SW 26TH Ave
Suite D
Mineral Wells, TX 76067-8251

Mailing address

218 SW 26TH Ave
Suite D
Mineral Wells, TX 76067-8251
Phone (940) 325-4925

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130610000443 TX Part B Supplier - Clinic/Group Practice 6406091131 Receives reassigned benefits from 1 practitioner
Practice locations: Mineral Wells, TX; Azle, TX

National Provider Directory

National Provider Directory

Locations

202 SW 25th Ave
Ste 600
Mineral Wells, TX 76067
Phone (940) 217-5969

218 SW 26th Ave
Ste D
Mineral Wells, TX 76067
Phone (940) 325-2526

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1353283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364428800000",
    "number": "1497099279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "218 SW 26TH AVE",
            "address_2": "SUITE D",
            "city": "MINERAL WELLS",
            "state": "TX",
            "postal_code": "760678251",
            "telephone_number": "940-325-4925",
            "fax_number": "940-325-4955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "218 SW 26TH AVE",
            "address_2": "SUITE D",
            "city": "MINERAL WELLS",
            "state": "TX",
            "postal_code": "760678251",
            "telephone_number": "940-325-4925",
            "fax_number": "940-325-4955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANDACE Y COVINGTON MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-19",
        "last_updated": "2013-03-28",
        "status": "A",
        "authorized_official_last_name": "COVINGTON",
        "authorized_official_first_name": "CANDACE",
        "authorized_official_middle_name": "Y",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "940-325-4925",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "N3581",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mineral Wells, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.