Candace S Willis, FNP
Individual provider Active NPI Family Nurse Practitioner · Erin, TN
NPI 1659627388 · NPPES record last updated Jul 24, 2024
Key facts
- NPI
- 1659627388
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- APN16883 (TN)
- Practice address
- 5001 E Main St
Erin, TN 37061-4115 - Phone
- (931) 289-4211
- Fax
- (731) 249-9003
- NPI assigned
- Jul 31, 2012
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 14
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Lexington Clinic Corp
Lexington Hospital Corporation
Practice addresses (Care Compare)
200 W Church St
Lexington, TN 38351-2038
Phone (731) 968-3646
Hospital & facility affiliations
- Houston County Community Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20121210000091 | TN | Practitioner - Nurse Practitioner | 5395997811 | Reassigns benefits to 7 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| APN16883 | TN | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Shamrock Community Hospital Inc | Current | Accepting new patients | |
| Lexington Family Physicians LLC | Family Medicine | Current |
Accepting new patients |
| Lexington Clinic Corp | Emergency Medicine | Current |
Accepting new patients |
| Lexington Hospital Corporation | Current |
Accepting new patients | |
| Lexington Hospital Corporation | Emergency Medicine | Current |
Accepting new patients |
| Millennia Medical LLC | Family Medicine | Past | Accepting new patients |
| Lexington Hospital Corporation | Past | Accepting new patients | |
| Lexington Hospital Corporation | Emergency Medicine | Past | Accepting new patients |
| Lexington Hospital Corporation | Past | Accepting new patients |
Locations
2545 N Washington Ave
Brownsville, TN 38012
Phone (731) 307-3777
2545 N Washington Ave
Ste 2
Brownsville, TN 38012
5001 E Main St
Erin, TN 37061
Phone (336) 944-6420
864 W Church St
Ste A
Lexington, TN 38351
Phone (731) 249-9777
270 W Church St
Ste A
Lexington, TN 38351
Phone (731) 968-0133
200 W Church St
Lexington, TN 38351
Phone (731) 968-1812
2718 Squirrel Hollow Dr
Linden, TN 37096
Phone (931) 587-2121
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | APN16883 | TN | |
| Family Medicine Physician | 207Q00000X | APN16883 | TN | |
| Internal Medicine Physician | 207R00000X | APN16883 | TN | |
| Pediatrics Physician | 208000000X | APN16883 | TN | |
| Diagnostic Radiology Physician | 2085R0202X | APN16883 | TN | |
| Surgery Physician | 208600000X | APN16883 | TN | |
| Physical Therapist | 225100000X | |||
| Occupational Therapist | 225X00000X | |||
| Family Nurse Practitioner | 363LF0000X | APN16883 | TN | Yes |
Addresses
Primary practice location
5001 E Main St
Erin, TN 37061-4115
Mailing address
5001 E Main St
Erin, TN 37061-4115
Phone (931) 289-4211
Other practice location 1
200 W Church St
Lexington, TN 38351-2038
Phone (336) 944-6420
Other practice location 2
2545 N Washington Ave
Brownsville, TN 38012-1610
Phone (931) 289-4211
Other providers in Erin, TN
- Ashley Vasilik
- Ashleigh Walters
- Erin Weakley
- Rachael Welborn
- Wildflower Counseling Services, LLC
- Robert Alan Wilson
- Michael A Wright
All providers in Erin, TN · Family Nurse Practitioner in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 24, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.