Individual provider Active NPI

Candace Sue Solomon

  • Nurse Practitioner
  • Cincinnati, OH
National Provider Identifier
1497422604
Registry record updated Oct 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN.325782 Issued in OH
Practice address
6121 Colerain Ave
Cincinnati, OH 45239-6417
Phone
(513) 354-2466
Fax
(513) 906-5477
NPI assigned
Aug 25, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2024

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 RN.325782 OH Primary

Addresses

Primary practice location

6121 Colerain Ave
Cincinnati, OH 45239-6417

Mailing address

6121 Colerain Ave
Cincinnati, OH 45239-6417
Phone (513) 354-2466

Other practice location 1

3101 Burnet Ave
Cincinnati, OH 45229-3014
Phone (513) 357-7289

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Cincinnati Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20241107003015 OH Practitioner - Nurse Practitioner 3173057593 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Proxy Healthcare LLCGroup PAC ID 6507399524, 15 clinicians

Practice addresses (Care Compare)

3570 Executive Dr
Suite 110
Uniontown, OH 44685-8712
Phone (330) 696-9430

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN.325782OHMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dedicated Ohio Holding, LLC CurrentSince Oct 27, 2024 Accepting new patients
Dedicated Ohio Holding LLC CurrentSince Nov 1, 2024 Accepting new patients

Locations

1395 NW 167th St
Miami Gardens, FL 33169
Phone (305) 831-4760

7642 Reading Rd
Cincinnati, OH 45237
Phone (513) 208-2880

6121 Colerain Ave
Cincinnati, OH 45239
Phone (513) 354-2466

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1629849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729555200000",
    "number": "1497422604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6121 COLERAIN AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452396417",
            "telephone_number": "513-354-2466",
            "fax_number": "513-906-5477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6121 COLERAIN AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452396417",
            "telephone_number": "513-354-2466",
            "fax_number": "513-906-5477"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3101 Burnet Ave",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "452293014",
            "country_code": "US",
            "telephone_number": "513-357-7289",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SOLOMON",
        "first_name": "CANDACE",
        "middle_name": "SUE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-25",
        "last_updated": "2024-10-22",
        "certification_date": "2024-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "RN.325782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Cincinnati",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Cincinnati",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Cincinnati",
            "address_1": "Cincinnati Health Department",
            "address_2": "3101 Burnet Ave",
            "city": "Cincinnati",
            "state": "OH",
            "country_code": "US",
            "postal_code": "45229",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.