Individual provider Active NPI

Candice Priscilla Gregg, ARNP

  • Nurse Practitioner
  • Tallahassee, FL
National Provider Identifier
1497268635
Registry record updated Jun 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN9324581 Issued in FL
Practice address
1401 Centerville Rd Ste 202
Tallahassee, FL 32308-4638
Phone
(850) 877-7241
Fax
(850) 877-1338
NPI assigned
Nov 9, 2017
Last updated
Jun 2, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN9324581 FL Primary
Obstetrics & Gynecology Nurse Practitioner 363LX0001X APRN9324581 FL

Addresses

Primary practice location

1401 Centerville Rd Ste 202
Tallahassee, FL 32308-4638

Mailing address

1401 Centerville Rd Ste 202
Tallahassee, FL 32308-4638
Phone (850) 877-7241

Other identifiers 1

IdentifierTypeStateIssuer
023394800MedicaidFL

Other names 1

  • Candice Priscilla Gregg Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20190611002983 FL Practitioner - Nurse Practitioner 0244563989

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
54.43 of 100Reported as group
Quality
57.3
Improvement activities
0
Cost
76.37

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN9324581FLMDNurse Practitioner
APRN9324581FLMDObstetrics & Gynecology Nurse Practitioner

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/28306/brand/1/csg/1/fhir/r4

NPI Registry JSON

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

{
    "created_epoch": "1510185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622592000000",
    "number": "1497268635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 CENTERVILLE RD STE 202",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323084638",
            "telephone_number": "850-877-7241",
            "fax_number": "850-877-1338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 CENTERVILLE RD STE 202",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323084638",
            "telephone_number": "850-877-7241",
            "fax_number": "850-877-1338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREGG",
        "first_name": "CANDICE",
        "middle_name": "PRISCILLA",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-09",
        "last_updated": "2021-06-02",
        "certification_date": "2021-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "RN9324581",
            "primary": true
        },
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "FL",
            "license": "APRN9324581",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "023394800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CANDICE",
            "last_name": "GREGG",
            "middle_name": "PRISCILLA",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Tallahassee, FL

Sources for this page

Verify at the official NPI Registry.