Individual provider Active NPI

Candice Marie Vann, RDN LN CLC

  • Registered Dietitian
  • Bozeman, MT
National Provider Identifier
1801370192
Registry record updated Sep 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
MED-NUTR-LIC-264 Issued in MT
Practice address
362 Annie Glade Dr
Bozeman, MT 59718-7685
Phone
(406) 223-0820
NPI assigned
Sep 21, 2018
Last updated
Sep 21, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 21, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nutritionist 133N00000X MED-NUTR-LIC-264 MT
Registered Dietitian 133V00000X MED-NUTR-LIC-264 MT Primary

Addresses

Primary practice location

362 Annie Glade Dr
Bozeman, MT 59718-7685

Mailing address

1043 Stoneridge Dr Ste 2
Bozeman, MT 59718-7084
Phone (406) 599-2492

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210603001610 MT Practitioner - Registered Dietitian Or Nutrition Professional 3173922648 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ncenter LLCGroup PAC ID 0547569204, 7 clinicians

Practice addresses (Care Compare)

1001 W Oak St
Suite 205
Bozeman, MT 59715-8757
Phone (480) 869-2826

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MED-NUTR-LIC-264MTMDNutritionist

Practice roles

OrganizationSpecialtyStatusNew patients
Ncenter, LLC Multi-Specialty CurrentSince May 25, 2021 Accepting new patients

Locations

1001 W Oak St
Ste 205
Bozeman, MT 59715
Phone (406) 581-1138

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": "1537488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537488000000",
    "number": "1801370192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1043 STONERIDGE DR STE 2",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597187084",
            "telephone_number": "406-599-2492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "362 ANNIE GLADE DR",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597187685",
            "telephone_number": "406-223-0820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANN",
        "first_name": "CANDICE",
        "middle_name": "MARIE",
        "credential": "RDN LN CLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-21",
        "last_updated": "2018-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "MT",
            "license": "MED-NUTR-LIC-264",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MT",
            "license": "MED-NUTR-LIC-264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bozeman, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.