Active NPI
Candice Rose Bagwell, COTA/L
- Occupational Therapy Assistant
- Pendleton, SC
National Provider Identifier
1699035642
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 3007
- Practice address
- 315 E Queen St
Pendleton, SC 29670-1721 - Phone
- (864) 403-2000
- NPI assigned
- May 24, 2012
- Last updated
- Sep 23, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 3007 | SC | Primary |
Addresses
Primary practice location
315 E Queen St
Pendleton, SC 29670-1721
Mailing address
315 E Queen St
Pendleton, SC 29670-1721
Phone (864) 403-2000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3007 | SC | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1337817600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1379894400000",
"number": "1699035642",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "315 E QUEEN ST",
"city": "PENDLETON",
"state": "SC",
"postal_code": "296701721",
"telephone_number": "864-403-2000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "315 E QUEEN ST",
"city": "PENDLETON",
"state": "SC",
"postal_code": "296701721",
"telephone_number": "864-403-2000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAGWELL",
"first_name": "CANDICE",
"middle_name": "ROSE",
"credential": "COTA/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-05-24",
"last_updated": "2013-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "SC",
"license": "3007",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pendleton, SC
- Anderson District 4
- Anderson School District Four
- Anmed Health (AnMed Primary Care - Pendleton)
- Arthur L. Bruce, DMD
- Jennifer Bagby, RPH
- Gregory Martin Bauld, RPH
- Felicia Skipper Berkeley, R.N.
- Bio-Medical Applications of South Carolina, Inc. (Fresenius Medical Care Pendleton)
- Zakiyyah Danielle Bosket
- Claudia Brabham, RN, IBCLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.