Candace M Madick, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

ARNP9268617 Issued in FL

Practice address

2703 N Ponce de Leon Blvd
St Augustine, FL 32084-2603

Phone

(904) 824-2838

NPI assigned

Apr 15, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Triad Health Services, LLC

  dba Southwoods Physician Services

  • Plastic Surgery Physician
  • Youngstown, OH
  • NPI 1588925457

  Family

  NPD (past)

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

{
    "created_epoch": "1302825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332115200000",
    "number": "1558651117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 ISLAND COTTAGE WAY",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320804404",
            "telephone_number": "904-471-6629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2703 N PONCE DE LEON BLVD",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320842603",
            "telephone_number": "904-824-2838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADICK",
        "first_name": "CANDACE",
        "middle_name": "M",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-15",
        "last_updated": "2012-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "COA12301-NP",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9268617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaylie Macgregor, DPT
• Miguel A Machado, MD
• Katelyn Emily Mackay
• Jennifer L Madden, MD
• Thomas Madden, PT, DPT
• Sherri Lee Maetozo, M.D.
• Eric Joseph Magnifico, DC
• Magnolia Integrative Wellness & Behavioral Health LLC
• Dipal Mahajan
• Atosa Mahjoory-Khan

• Family Nurse Practitioner in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.