Individual provider Active NPI

Sandi Kay Candella, P.A.

  • Surgical Physician Assistant
  • Rock Hill, SC
National Provider Identifier
1568633824
Registry record updated Apr 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
3053 Issued in SC
Practice address
197 Piedmont Blvd Ste 100
Rock Hill, SC 29732-1825
Phone
(803) 324-1950
Fax
(803) 324-1933
NPI assigned
Mar 14, 2008
Last updated
Apr 18, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 001002076 NC
Surgical Physician Assistant 363AS0400X 5274 GA
Surgical Physician Assistant 363AS0400X 3053 SC Primary

Addresses

Primary practice location

197 Piedmont Blvd Ste 100
Rock Hill, SC 29732-1825

Mailing address

10650 Park Rd
Suite 220
Charlotte, NC 28210-8538
Phone (704) 667-3840

Other practice location 1

10650 Park Rd
Suite 220
Charlotte, NC 28210-8538
Phone (704) 667-3840

Other identifiers 2

IdentifierTypeStateIssuer
8102022MedicaidNC
1568633824MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, MO, SC3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20220802001883 IL Practitioner - Physician Assistant 6800965773 Reassigns benefits to 1 organization
I20230623002327 MO Practitioner - Physician Assistant 6800965773 Reassigns benefits to 1 organization
I20231025002757 SC Practitioner - Physician Assistant 6800965773 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piedmont Physician Network LLCGroup PAC ID 7911287552, 92 clinicians
Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

200 Herlong Ave S
Rock Hill, SC 29732-1182

222 Herlong Ave S
Rock Hill, SC 29732-1158
Phone (803) 324-1950

222 S Herlong Ave
Rock Hill, SC 29732-1158
Phone (803) 329-1234

8600 State Route 91
Suite 130
Peoria, IL 61615-7829
Phone (309) 683-5050

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1500NHMDOccupational Therapist
001002076NCMDPhysician Assistant
5274GAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Central PA Pharmacy LLC. Current Accepting new patients
Saint Francis Medical Center CurrentSince Jun 21, 2023 Accepting new patients
Saint Francis Medical Center CurrentSince Jun 21, 2023 Accepting new patients
Health Services of Central Georgia, Inc PastSince Feb 1, 2015 Accepting new patients

Locations

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

211 Saint Francis Dr
Cpe Girardeau, MO 63703
Phone (573) 331-3000

Interoperability endpoints

  • Direct secure messaging: sandi.candella.1@14929.direct.athenahealth.com

Organizations & group practices 7

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1205452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713398400000",
    "number": "1568633824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10650 PARK RD",
            "address_2": "SUITE 220",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282108538",
            "telephone_number": "704-667-3840",
            "fax_number": "704-667-3899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "197 PIEDMONT BLVD STE 100",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297321825",
            "telephone_number": "803-324-1950",
            "fax_number": "803-324-1933"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10650 Park Rd",
            "address_2": "Suite 220",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282108538",
            "country_code": "US",
            "telephone_number": "704-667-3840",
            "fax_number": "704-667-3899",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CANDELLA",
        "first_name": "SANDI",
        "middle_name": "KAY",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-14",
        "last_updated": "2024-04-18",
        "certification_date": "2024-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "001002076",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "GA",
            "license": "5274",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "SC",
            "license": "3053",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8102022",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1568633824",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rock Hill, SC

Sources for this page

Verify at the official NPI Registry.