Active NPI
Candace Oen, P. A. -C.
- Physician Assistant
- Dewey, AZ
National Provider Identifier
1508060930
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 2077
- Practice address
- 13175 E Highway 169
Dewey, AZ 86327-7372 - Phone
- (928) 632-0111
- NPI assigned
- Jun 11, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 2077 | AZ | Primary |
Addresses
Primary practice location
13175 E Highway 169
Dewey, AZ 86327-7372
Mailing address
PO Box 1046
Dewey, AZ 86327-1046
Phone (928) 632-8278
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2077 | AZ | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181520000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1508060930",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1046",
"city": "DEWEY",
"state": "AZ",
"postal_code": "863271046",
"telephone_number": "928-632-8278",
"fax_number": "928-632-0105"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13175 E HIGHWAY 169",
"city": "DEWEY",
"state": "AZ",
"postal_code": "863277372",
"telephone_number": "928-632-0111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OEN",
"first_name": "CANDACE",
"credential": "P. A. -C.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-06-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "AZ",
"license": "2077",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dewey, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.