Individual provider Active NPI

Candace Brooke Dulabh, PA-C

  • Physician Assistant
  • Owensboro, KY
National Provider Identifier
1588960397
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
TC356 Issued in KY
Practice address
1000 Breckenridge St
Suite 401
Owensboro, KY 42303-0839
Phone
(270) 688-4401
Fax
(270) 688-4409
NPI assigned
Jan 27, 2011
Last updated
Nov 27, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X TC356 KY Primary
Medical Physician Assistant 363AM0700X NU

Addresses

Primary practice location

1000 Breckenridge St
Suite 401
Owensboro, KY 42303-0839

Mailing address

PO Box 23229
Owensboro, KY 42304-3229
Phone (270) 688-4401

Other names 1

  • Candace Brooke Brown Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cdulabh50588@direct.owensborohealth.org Owensboro Health Medical Group, Inc

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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 1

Enrollment IDStateProvider typePAC IDDetails
I20150304000381 KY Practitioner - Physician Assistant 9436337284 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Kentucky College of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Owensboro Health, IncGroup PAC ID 0547154650, shared by 9 NPIs, 179 clinicians

Practice addresses (Care Compare)

1000 Breckenridge St
Suite 401
Owensboro, KY 42303-0878
Phone (270) 688-4401

1006 Ford Ave
Owensboro, KY 42301-4677
Phone (270) 688-4845

2211 Mayfair Dr
Owensboro, KY 42301-4569

PO Box
Suite 23229
Owensboro, KY 42304-3229

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
TC356KYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Owensboro Health Medical Group Inc CurrentSince Feb 2, 2015 Accepting new patients
Owensboro Health Medical Group, Inc. CurrentSince Feb 2, 2015 Accepting new patients
Owensboro Health Medical Group, Inc Physician Assistant Past Accepting new patients

Locations

1000 Breckenridge St
Ste 401
Owensboro, KY 42303
Phone (270) 685-1066

2211 Mayfair Dr
Ste 101
Owensboro, KY 42301
Phone (270) 688-1352

2211 Mayfair Dr
Ste 102
Owensboro, KY 42301
Phone (270) 688-1351

Interoperability endpoints

  • Direct secure messaging: cdulabh50588@direct.owensborohealth.org

Organizations & group practices 4

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 1

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": "1296086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1588960397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23229",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423043229",
            "telephone_number": "270-688-4401",
            "fax_number": "270-688-4409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 BRECKENRIDGE ST",
            "address_2": "SUITE 401",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423030839",
            "telephone_number": "270-688-4401",
            "fax_number": "270-688-4409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DULABH",
        "first_name": "CANDACE",
        "middle_name": "BROOKE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-27",
        "last_updated": "2023-11-27",
        "certification_date": "2020-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "TC356",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cdulabh50588@direct.owensborohealth.org",
            "affiliation": "Y",
            "affiliationName": "Owensboro Health Medical Group, Inc",
            "address_1": "1000 Breckenridge St",
            "address_2": "Suite 401",
            "city": "Owensboro",
            "state": "KY",
            "country_code": "US",
            "postal_code": "423030839",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "CANDACE",
            "last_name": "BROWN",
            "middle_name": "BROOKE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Owensboro, KY

Sources for this page

Verify at the official NPI Registry.