Individual provider Active NPI

Candise Ann Love, RN

  • Acute Care Nurse Practitioner
  • Port Huron, MI
National Provider Identifier
1801102371
Registry record updated Aug 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
4704261280 Issued in MI
Practice address
1231 Pine Grove Ave
Ste 2F
Port Huron, MI 48060-3500
Phone
(810) 982-5200
NPI assigned
Aug 23, 2010
Last updated
Aug 1, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 4704261280 MI Primary
Oncology Registered Nurse 163WX0200X 4704261280 MI

Addresses

Primary practice location

1231 Pine Grove Ave
Ste 2F
Port Huron, MI 48060-3500

Mailing address

1231 Pine Grove Ave
Ste 2F
Port Huron, MI 48060-3500
Phone (810) 982-5200

Other identifiers 1

IdentifierTypeStateIssuer
1801102371MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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 1

Enrollment IDStateProvider typePAC IDDetails
I20110513000432 MI Practitioner - Nurse Practitioner 8123204823 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Huron Medical Center PCGroup PAC ID 0648283929, 9 clinicians

Practice addresses (Care Compare)

1221 Pine Grove Ave
FL 2
Port Huron, MI 48060-3511
Phone (810) 982-5200

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704261280MIMDOncology Registered Nurse

Interoperability endpoints

  • Direct secure messaging: candise.love@hmcpc.direct-geniusdoc.com

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.

Hospital & facility affiliations 2

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": "1282521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470009600000",
    "number": "1801102371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1231 PINE GROVE AVE",
            "address_2": "STE 2F",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480603500",
            "telephone_number": "810-982-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1231 PINE GROVE AVE",
            "address_2": "STE 2F",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480603500",
            "telephone_number": "810-982-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOVE",
        "first_name": "CANDISE",
        "middle_name": "ANN",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-23",
        "last_updated": "2016-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MI",
            "license": "4704261280",
            "primary": true
        },
        {
            "code": "163WX0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Oncology",
            "state": "MI",
            "license": "4704261280",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1801102371",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Huron, MI

Sources for this page

Verify at the official NPI Registry.