Individual provider Active NPI

Candice L Nelson, MD

  • Pediatrics Physician
  • Sioux Falls, SD
National Provider Identifier
1629024997
Registry record updated May 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
4890 Issued in SD
Practice address
6101 S Louise Ave
Sioux Falls, SD 57108-5981
Phone
(605) 312-8000
Fax
(605) 312-8001
NPI assigned
May 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 4890 SD Primary
Pediatrics Physician 208000000X R-5860 IA

Addresses

Primary practice location

6101 S Louise Ave
Sioux Falls, SD 57108-5981

Mailing address

PO Box 5074
Sioux Falls, SD 57117-5074
Phone (605) 312-7605

Other practice location 1

4405 E 26th St
Sioux Falls, SD 57103-4187
Phone (605) 328-9080

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
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
I20040519001486 SD Practitioner - Pediatric Medicine 3375534241 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R-5860IAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Clinic Current Accepting new patients
Sanford Clinic CurrentSince Feb 1, 2002 Accepting new patients
Sanford Medical Center CurrentSince Aug 9, 2012 Accepting new patients
Sanford Clinic CurrentSince Feb 1, 2002 Accepting new patients

Locations

525 N Foster St
Mitchell, SD 57301
Phone (605) 995-2000

6101 S Louise Ave
Sioux Falls, SD 57108
Phone (605) 312-8000

4405 E 26th St
Sioux Falls, SD 57103
Phone (605) 328-9000

1500 W 22nd St
Ste 102
Sioux Falls, SD 57105
Phone (605) 328-8800

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590537600000",
    "number": "1629024997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5074",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175074",
            "telephone_number": "605-312-7605",
            "fax_number": "605-312-7611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6101 S LOUISE AVE",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571085981",
            "telephone_number": "605-312-8000",
            "fax_number": "605-312-8001"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4405 E 26th St",
            "address_purpose": "LOCATION",
            "city": "Sioux Falls",
            "state": "SD",
            "postal_code": "571034187",
            "country_code": "US",
            "telephone_number": "605-328-9080",
            "fax_number": "605-328-9081",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NELSON",
        "first_name": "CANDICE",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-26",
        "last_updated": "2020-05-27",
        "certification_date": "2020-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "SD",
            "license": "4890",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IA",
            "license": "R-5860",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

Verify at the official NPI Registry.