Individual provider Active NPI

Candace M Kernell, CFNP

  • Nurse Practitioner
  • Fort Sumner, NM
National Provider Identifier
1770133746
Registry record updated Jul 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
59801 Issued in 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
Last updated
Jul 26, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 856514 TX
Nurse Practitioner 363L00000X AP143246 TX
Family Nurse Practitioner 363LF0000X AP143246 TX
Nurse Practitioner 363L00000X 59801 NM Primary

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 1

TypeEndpointUseAffiliation
Direct Messaging Address candace.lyssy@direct.myteamcare.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, NM2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20191102000104 TX Practitioner - Nurse Practitioner 5294067773 Reassigns benefits to 1 organization
I20240612003459 NM Practitioner - Nurse Practitioner 5294067773 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
De Baca Family Practice ClinicGroup PAC ID 6406758358, 3 clinicians

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

Merit-based Incentive Payment System (MIPS)

Final score
99.52 of 100Reported as apm
Quality
87.98
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
856514TXMDRegistered Nurse
59801NMMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
De Baca Family Practice Clinic Current Accepting new patients
Texas Tech University Health Sciences Center Lubbock CurrentSince Oct 16, 2019 Accepting new patients
Texas Tech University Health Sciences Center Lubbock Current Accepting new patients
De Baca Family Practice Clinic CurrentSince Jun 10, 2024 Accepting new patients
De Baca Family Practice Clinic CurrentSince Jun 10, 2024 Accepting new patients
Texas Tech University Health Sciences Center Lubbock CurrentSince Oct 16, 2019 Accepting new patients

Locations

602 Indiana Ave
Lubbock, TX 79415
Phone (806) 743-2898

Interoperability endpoints

  • Direct secure messaging: candace.lyssy@direct.myteamcare.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • FHIR API: https://fhir4.healow.com/fhir/r4/DGGJCD

Organizations & group practices 6

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": "1568246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721952000000",
    "number": "1770133746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "546 N. 10TH STREET",
            "city": "FORT SUMNER",
            "state": "NM",
            "postal_code": "881190349",
            "telephone_number": "575-355-2414",
            "fax_number": "575-355-7894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "546 N. 10TH STREET",
            "city": "FORT SUMNER",
            "state": "NM",
            "postal_code": "881190349",
            "telephone_number": "575-355-2414",
            "fax_number": "575-355-7894"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "602 Indiana Ave",
            "address_purpose": "LOCATION",
            "city": "Lubbock",
            "state": "TX",
            "postal_code": "794153364",
            "country_code": "US",
            "telephone_number": "806-775-8600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KERNELL",
        "first_name": "CANDACE",
        "middle_name": "M",
        "credential": "CFNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-12",
        "last_updated": "2024-07-26",
        "certification_date": "2024-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "856514",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP143246",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP143246",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NM",
            "license": "59801",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "candace.lyssy@direct.myteamcare.com",
            "affiliation": "N",
            "address_1": "602 Indiana Ave",
            "city": "Lubbock",
            "state": "TX",
            "country_code": "US",
            "postal_code": "794153364",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Sumner, NM

Sources for this page

Verify at the official NPI Registry.