Candis M Lovelace, M.D.

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

License

N3845 Issued in TX

Practice address

4400 Heritage Trace Parkway
Suite 200
Fort Worth, TX 76244

Phone

(817) 380-1087

Fax

(817) 380-1088

NPI assigned

Feb 7, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Dr. Candis M Thackara Former name

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Plastic and Reconstructive Surgery

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Medical City Alliance Hospital, Fort Worth, TX, CCN 670103
• Texas Health Harris Methodist Hospital Alliance Hospital, Fort Worth, TX, CCN 670085

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: clovelace@directaddress.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Candis Lovelace MD PA

  • Plastic Surgery Physician
  • Aurora, TX
  • NPI 1316212129
  Medicare reassignment NPD Authorized official
• Wise Clinical Care Associates

  • Family Medicine Physician
  • Bridgeport, TX
  • NPI 1679719801
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• North Texas - Mca LLC

  • General Acute Care Hospital
  • Fort Worth, TX
  • NPI 1871911016
  Care Compare affiliation
• Texas Health Harris Methodist Hospital Alliance

  • General Acute Care Hospital
  • Fort Worth, TX
  • NPI 1215296884
  Care Compare affiliation

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344902400000",
    "number": "1811037245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4400 HERITAGE TRACE PARKWAY",
            "address_2": "SUITE 200",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "76244",
            "telephone_number": "817-380-1087",
            "fax_number": "817-380-1088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 HERITAGE TRACE PARKWAY",
            "address_2": "SUITE 200",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "76244",
            "telephone_number": "817-380-1087",
            "fax_number": "817-380-1088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOVELACE",
        "first_name": "CANDIS",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-07",
        "last_updated": "2012-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "TX",
            "license": "N3845",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "208491501",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8CC632",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CANDIS",
            "last_name": "THACKARA",
            "middle_name": "M",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Johanna Love, LPC
• Lareasha Love, LPC
• Laticia Love
• Mary Lovegren
• Lovelace Home Care Agency LLC
• Kimberly Lincoln Lovelace, LPC
• Sophia Lovelace
• Kathy Lovelady
• Garrett Darren Loveland
• Aria Loveless-Green

• Plastic and Reconstructive Surgery Physician in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Plastic and Reconstructive Surgery Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.