Candace M Kernell, CFNP
Individual provider Active NPI Nurse Practitioner · Fort Sumner, NM
NPI 1770133746 · NPPES record last updated Jul 26, 2024
Key facts
- NPI
- 1770133746
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 59801 (NM)
- Practice address
- 546 N. 10TH Street
Fort Sumner, NM 88119-0349 - Phone
- (575) 355-2414
- Fax
- (575) 355-7894
- NPI assigned
- Sep 12, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 6
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- De Baca Family Practice Clinic
Practice addresses (Care Compare)
1001 Sumner Ave
De Baca Family Practice/ SBHC
Fort Sumner, NM 88119-0349
Phone (575) 355-4431
546 N 10TH St
Fort Sumner, NM 88119
Phone (575) 355-2414
PO Box
Suite 349
Fort Sumner, NM 88119
PO Box
Suite 349
Fort Sumner, NM 88119-0349
Hospital & facility affiliations
- Excelacare Home Health
- Plains Regional Medical Center
- Guadalupe County Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 99.52 of 100
- Quality
- 87.98
- Promoting interoperability
- 100
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in TX, NM
- 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 |
|---|---|---|---|---|
| I20191102000104 | TX | Practitioner - Nurse Practitioner | 5294067773 | Reassigns benefits to 1 organization |
| I20240612003459 | NM | Practitioner - Nurse Practitioner | 5294067773 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 856514 | TX | MD | Registered Nurse |
| 59801 | NM | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Texas Tech University Health Sciences Center Lubbock | Current | Accepting new patients | |
| De Baca Family Practice Clinic | Current |
Accepting new patients | |
| Texas Tech University Health Sciences Center Lubbock | Current |
Accepting new patients | |
| De Baca Family Practice Clinic | Current | Accepting new patients | |
| Texas Tech University Health Sciences Center Lubbock | Current |
Accepting new patients | |
| De Baca Family Practice Clinic | Current |
Accepting new patients |
Locations
602 Indiana Ave
Lubbock, TX 79415
Phone (806) 743-2898
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/DGGJCD
- candace.lyssy@direct.myteamcare.com
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 856514 | TX | |
| Nurse Practitioner | 363L00000X | AP143246 | TX | |
| Family Nurse Practitioner | 363LF0000X | AP143246 | TX | |
| Nurse Practitioner | 363L00000X | 59801 | NM | Yes |
Addresses
Primary practice location
546 N. 10TH Street
Fort Sumner, NM 88119-0349
Mailing address
546 N. 10TH Street
Fort Sumner, NM 88119-0349
Phone (575) 355-2414
Other practice location 1
602 Indiana Ave
Lubbock, TX 79415-3364
Phone (806) 775-8600
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | candace.lyssy@direct.myteamcare.com |
Other providers in Fort Sumner, NM
- Jessie Gallegos
- Mary Elizabeth Hetsko
- Dorene Jaramillo
- Darlene G Jenkins
- Mary M Kenyon
- Kelsey Kohler
- Shelly Renee Landreth
- Kevin Alan Martinez
- Mayra Maria Mendoza
- Mental Health Resources, Inc.
All providers in Fort Sumner, NM · Nurse Practitioner in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 26, 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.