Individual provider Active NPI

Candice Michelle McGowan, FNP-BC

  • Family Nurse Practitioner
  • Independence, MO
National Provider Identifier
1639403876
Registry record updated Nov 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2004008683 Issued in MO
Practice address
19401 E 39TH St S
Independence, MO 64057-2308
Phone
(816) 490-4277
Fax
(855) 446-7160
NPI assigned
Sep 21, 2009
Last updated
Nov 29, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2004008683 MO Primary

Addresses

Primary practice location

19401 E 39TH St S
Independence, MO 64057-2308

Mailing address

PO Box 616788
Orlando, FL 32861-6788
Phone (407) 447-7120

Other identifiers 1

IdentifierTypeStateIssuer
2004008683OtherMONURSE PRACTITIONER LICENSURE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address candice.mcgowan@centerwell.eclinicaldirectplus.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20091013000599 MO Practitioner - Nurse Practitioner 3173669785 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

19401 E 39TH St S
Independence, MO 64057-2308
Phone (816) 490-4277

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2004008683MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Centerwell Senior Primary Care (Mo) PC CurrentSince Jan 1, 2021 Accepting new patients
Centerwell Senior Primary Care (Mo) PC Current Accepting new patients
Centerwell Senior Primary Care (Mo) PC CurrentSince Jan 1, 2021 Accepting new patients
Platte County Health Department Past Accepting new patients
Centerwell Senior Primary Care (Mo) PC Past Accepting new patients

Locations

6416 Old Winter Garden Rd
Orlando, FL 32835
Phone (407) 281-1755

1513 Main St
Grandview, MO 64030
Phone (816) 731-1890

19401 E 39th St S
Independence, MO 64057
Phone (816) 490-4277

9300 E Gregory Blvd
Ste A
Raytown, MO 64133
Phone (816) 608-8139

Interoperability endpoints

  • Direct secure messaging: candice.mcgowan.1@29601.direct.athenahealth.com
  • Direct secure messaging: candice.mcgowan@centerwell.eclinicaldirectplus.com
  • FHIR API: https://fhir-myrecord.cerner.com/r4/ad54ccf5-596b-429b-98f6-1f67d232e0e5/

Organizations & group practices 5

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 3

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": "1253491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638144000000",
    "number": "1639403876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 616788",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328616788",
            "telephone_number": "407-447-7120",
            "fax_number": "407-770-0661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19401 E 39TH ST S",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640572308",
            "telephone_number": "816-490-4277",
            "fax_number": "855-446-7160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGOWAN",
        "first_name": "CANDICE",
        "middle_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-21",
        "last_updated": "2021-11-29",
        "certification_date": "2021-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2004008683",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSE PRACTITIONER LICENSURE",
            "identifier": "2004008683",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "candice.mcgowan@centerwell.eclinicaldirectplus.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "19401 E 39th St S",
            "city": "Independence",
            "state": "MO",
            "country_code": "US",
            "postal_code": "640572308",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Independence, MO

Sources for this page

Verify at the official NPI Registry.