Individual provider Active NPI

Candice Michelle Loughery, MD

  • Obstetrics & Gynecology Physician
  • Philadelphia, PA
National Provider Identifier
1528405388
Registry record updated Jun 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
MT204763 Issued in PA
Practice address
800 Spruce St
Philadelphia, PA 19107-6130
Phone
(215) 829-3470
NPI assigned
Jun 3, 2013
Last updated
Jun 8, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X MT204763 PA
Obstetrics & Gynecology Physician 207V00000X MT204763 PA Primary

Addresses

Primary practice location

800 Spruce St
Philadelphia, PA 19107-6130

Mailing address

800 Spruce St
Philadelphia, PA 19107-6130
Phone (215) 829-3470

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20170731001006 PA Practitioner - Obstetrics/Gynecology 7911278676 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT204763PAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
HR Physician Services CurrentSince Oct 20, 2021 Accepting new patients
HR Physician Services CurrentSince Oct 20, 2021 Accepting new patients
HR Physician Services Obstetrics & Gynecology Current Accepting new patients
Holy Redeemer Health System Past Accepting new patients

Locations

3300 Tillman Dr
Bensalem, PA 19020
Phone (215) 244-7400

109 Central Ave
Cheltenham, PA 19012
Phone (215) 663-1500

1648 Huntingdon Pike
Meadowbrook, PA 19046
Phone (215) 938-3413

1650 Huntingdon Pike
Ste 118
Meadowbrook, PA 19046
Phone (215) 914-2600

7390 Bustleton Ave
Philadelphia, PA 19152
Phone (215) 268-9480

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1370217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370649600000",
    "number": "1528405388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 SPRUCE ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191076130",
            "telephone_number": "215-829-3470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 SPRUCE ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191076130",
            "telephone_number": "215-829-3470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOUGHERY",
        "first_name": "CANDICE",
        "middle_name": "MICHELLE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-03",
        "last_updated": "2013-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PA",
            "license": "MT204763",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "PA",
            "license": "MT204763",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.