Individual provider Active NPI

Candice Bertsch, CRNP

  • Family Nurse Practitioner
  • Dothan, AL
National Provider Identifier
1841920030
Registry record updated Aug 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1-121859 Issued in AL
Practice address
287 Healthwest Dr
Dothan, AL 36303-2031
Phone
(334) 792-9500
Fax
(334) 793-1815
NPI assigned
Jun 13, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1-121859 AL Primary

Addresses

Primary practice location

287 Healthwest Dr
Dothan, AL 36303-2031

Mailing address

287 Healthwest Dr
Dothan, AL 36303-2031
Phone (334) 792-9500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20220909000659 AL Practitioner - Nurse Practitioner 6608251798 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

287 Healthwest Dr
Dothan, AL 36303-2031
Phone (334) 792-9500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.12 of 100Reported as group
Promoting interoperability
85
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dothan Hematology & Oncology PC CurrentSince Aug 15, 2022 Accepting new patients
Dothan Hematology & Oncology PC CurrentSince Aug 15, 2022 Accepting new patients

Locations

287 Healthwest Dr
Dothan, AL 36303
Phone (334) 792-9500

1118 Ross Clark Cir
Ste 200
Dothan, AL 36301
Phone (334) 793-4804

Organizations & group practices 2

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.

Hospital & facility affiliations 4

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": "1655078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661817600000",
    "number": "1841920030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "287 HEALTHWEST DR",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363032031",
            "telephone_number": "334-792-9500",
            "fax_number": "334-793-1815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "287 HEALTHWEST DR",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363032031",
            "telephone_number": "334-792-9500",
            "fax_number": "334-793-1815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERTSCH",
        "first_name": "CANDICE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-13",
        "last_updated": "2022-08-30",
        "certification_date": "2022-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-121859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dothan, AL

Sources for this page

Verify at the official NPI Registry.