Individual provider Active NPI

Candace Dick, M.D.

  • Cardiovascular Disease Physician
  • Edina, MN
National Provider Identifier
1811974777
Registry record updated Oct 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
30804 Issued in MN
Practice address
6405 France Ave S
Suite W200
Edina, MN 55435-2163
Phone
(952) 924-9005
Fax
(952) 924-0330
NPI assigned
Dec 30, 2005
Last updated
Oct 25, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 30804 MN Primary

Addresses

Primary practice location

6405 France Ave S
Suite W200
Edina, MN 55435-2163

Mailing address

6405 France Ave S
Suite W200
Edina, MN 55435-2163
Phone (952) 924-9005

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
30804MNMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Express Care Cardiovascular Disease Past Accepting new patients

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": "1135900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351123200000",
    "number": "1811974777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6405 FRANCE AVE S",
            "address_2": "SUITE W200",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554352163",
            "telephone_number": "952-924-9005",
            "fax_number": "952-924-0330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6405 FRANCE AVE S",
            "address_2": "SUITE W200",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554352163",
            "telephone_number": "952-924-9005",
            "fax_number": "952-924-0330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICK",
        "first_name": "CANDACE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-30",
        "last_updated": "2012-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MN",
            "license": "30804",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edina, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.