Individual provider Active NPI

Tachele C Candia Anderson, MD

  • Pediatrics Physician
  • Memphis, TN
National Provider Identifier
1508445693
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
71726 Issued in TN
Practice address
51 N Dunlap St
Memphis, TN 38105-4625
Phone
(901) 287-7337
Fax
(901) 287-4646
NPI assigned
Apr 6, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 71726 TN Primary

Addresses

Primary practice location

51 N Dunlap St
Memphis, TN 38105-4625

Mailing address

850 Poplar Ave BLDG 2
Memphis, TN 38105-4607
Phone (901) 287-5594

Other practice location 1

848 Adams Ave
Memphis, TN 38103-2816
Phone (901) 287-7337

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240807003852 TN Practitioner - Pediatric Medicine 9830636869 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Ut Lebonheur Pediatric Specialists, Inc. Pediatrics CurrentSince Jul 1, 2024 Accepting new patients

Locations

850 Poplar Ave
Bldg 2
Memphis, TN 38105
Phone (901) 287-5594

100 N Humphreys Blvd
Memphis, TN 38120
Phone (901) 747-1800

50 N Dunlap St
#20
Memphis, TN 38103
Phone (901) 287-6756

848 Adams Ave
Memphis, TN 38103
Phone (901) 287-5437

Interoperability endpoints

  • Direct secure messaging: tcandiaanderson44723@mlh.direct-ci.com

Organizations & group practices 1

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": "1617667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1508445693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 POPLAR AVE BLDG 2",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381054607",
            "telephone_number": "901-287-5594",
            "fax_number": "901-287-5595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 N DUNLAP ST",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381054625",
            "telephone_number": "901-287-7337",
            "fax_number": "901-287-4646"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "848 Adams Ave",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381032816",
            "country_code": "US",
            "telephone_number": "901-287-7337",
            "fax_number": "901-287-4646",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CANDIA ANDERSON",
        "first_name": "TACHELE",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-06",
        "last_updated": "2024-07-15",
        "certification_date": "2024-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TN",
            "license": "71726",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.