Individual provider Active NPI

Candace Thornton Spann, M.D.

  • Dermatology Physician
  • Las Vegas, NV
National Provider Identifier
1700964780
Registry record updated Aug 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
13132 Issued in NV
Practice address
2615 Box Canyon Dr
Las Vegas, NV 89128-0450
Phone
(702) 998-8486
Fax
(702) 998-8282
NPI assigned
Nov 1, 2006
Last updated
Aug 9, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 230915 NY
Dermatology Physician 207N00000X 13132 NV Primary

Addresses

Primary practice location

2615 Box Canyon Dr
Las Vegas, NV 89128-0450

Mailing address

2615 Box Canyon Dr
Las Vegas, NV 89128-0450
Phone (702) 998-8486

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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
I20090915000584 NV Practitioner - Dermatology 5597702175 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Meharry Medical College School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Marvin D Spann MD PLLCGroup PAC ID 6002066024, 5 clinicians

Practice addresses (Care Compare)

9950 W Flamingo Rd
Suite 105
Las Vegas, NV 89147-8555
Phone (702) 998-8486

Merit-based Incentive Payment System (MIPS)

Final score
88.93 of 100Reported as individual
Quality
77.86
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision14
Removal of skin lesions291
Removal or shaving of skin growth16
Skin biopsy101

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
13132NVMDDermatology Physician

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344470400000",
    "number": "1700964780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2615 BOX CANYON DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891280450",
            "telephone_number": "702-998-8486",
            "fax_number": "702-998-8282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2615 BOX CANYON DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891280450",
            "telephone_number": "702-998-8486",
            "fax_number": "702-998-8282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPANN",
        "first_name": "CANDACE",
        "middle_name": "THORNTON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2012-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NY",
            "license": "230915",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NV",
            "license": "13132",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.