Candice Joy Stephenson, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA9108303 Issued in FL

Practice address

836 Prudential Dr
Suite 1601
Jacksonville, FL 32207-8334

Phone

(904) 396-8060

Fax

(904) 396-9700

NPI assigned

May 11, 2015

Sex

Female

Sole proprietor

Yes

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

• Candice Joy Eisenmann Former name

Medicare fee-for-service enrollment

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Zhi Yu, MD, PLLC

  • Geriatric Medicine (Family Medicine) Physician
  • Jacksonville, FL
  • NPI 1316273535
  Medicare reassignment
• Baptist ENT Specialists Inc

  • Otolaryngology Physician
  • Jacksonville, FL
  • NPI 1114306024
  NPD (past)

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

{
    "created_epoch": "1431302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447718400000",
    "number": "1811375918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 41516",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322031516",
            "telephone_number": "904-202-5111",
            "fax_number": "904-396-9700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "836 PRUDENTIAL DR",
            "address_2": "SUITE 1601",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078334",
            "telephone_number": "904-396-8060",
            "fax_number": "904-396-9700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHENSON",
        "first_name": "CANDICE",
        "middle_name": "JOY",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-05-11",
        "last_updated": "2015-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9108303",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "014983500",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01498314",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CANDICE",
            "last_name": "EISENMANN",
            "middle_name": "JOY",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ronald James Stephens, M.D.
• Roslyn Stephens, RN, LMT
• Stephanie Marie Stephens, APRN
• Takesha Hughes Stephens
• Toni Marie Stephens, LCSW
• Emily Paige Stephenson, DO
• James Devin Stephenson, DO
• Juliet Stephenson, LMHC, LPC
• Angelia Lenae Stepien
• Erica J Stepko, PT

• Medical Physician Assistant in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Medical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.