Candace Fowlkes

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704323451 Issued in MI

Practice address

880 W Long Lake Rd
Troy, MI 48098-4504

Phone

(866) 449-6828

NPI assigned

Apr 19, 2016

Last updated

Mar 17, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI, FL, CA, SC, KY, CT6 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 6

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Ih Physician Services PC

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Clinton Township, MI
  • NPI 1881432060
  Medicare reassignment NPD
• Central Health Plan of California, Inc.

  • Health Maintenance Organization
  • Diamond Bar, CA
  • NPI 1386714772
  Medicare reassignment NPD
• Molina Care Connections, LLC.

  dba Molina CC

  • Nurse Practitioner
  • Long Beach, CA
  • NPI 1407243223

  CT, FL, KY, MI, SC

  Medicare reassignment NPD
• Molina Healthcare of California

  dba Molina Medical Centers

  • Health Maintenance Organization
  • Long Beach, CA
  • NPI 1194811760
  Medicare reassignment NPD
• Ih Physician Services, PC

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Knoxville, TN
  • NPI 1770469389
  NPD
• Ih Physician Services PC

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Midland, MI
  • NPI 1437960101
  NPD (past)

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

{
    "created_epoch": "1461024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679011200000",
    "number": "1568816213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 STEWART RD",
            "city": "MONROE",
            "state": "MI",
            "postal_code": "481625304",
            "telephone_number": "313-629-5759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "880 W LONG LAKE RD",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480984504",
            "telephone_number": "866-449-6828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOWLKES",
        "first_name": "CANDACE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-19",
        "last_updated": "2023-03-17",
        "certification_date": "2023-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704323451",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kai A Forte, NP
• Hannah Elizabeth Fortune
• Caitlyn Foster, PA-C
• Deanna Madora Foster
• Kara Anne Fowler, PT, DPT, ATC
• Kimberly Anne Fox, FNP-C
• Marie Annette Fox, LMSW
• Jennifer Elizabeth Fraboni, PT,DPT
• Dana Fradi
• Evan Fradi

• Family Nurse Practitioner in Troy, MI
• Providers in Troy, MI by specialty
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.