Individual provider Active NPI

Victor Ignacio Candelario, APRN

  • Family Nurse Practitioner
  • Charlotte, NC
National Provider Identifier
1851621536
Registry record updated Apr 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5010300 Issued in NC
Practice address
5935 Providence Glen Rd
Charlotte, NC 28270-3722
Phone
(980) 457-5645
NPI assigned
Jan 3, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 16, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X ARNP9221773 FL
Family Nurse Practitioner 363LF0000X 5010300 NC Primary
Family Nurse Practitioner 363LF0000X 95005933 CA

Addresses

Primary practice location

5935 Providence Glen Rd
Charlotte, NC 28270-3722

Mailing address

5935 Providence Glen Rd
Charlotte, NC 28270-3722
Phone (980) 457-5645

Other identifiers 1

IdentifierTypeStateIssuer
004180600MedicaidFL

Other names 1

  • Victor Klingshirn Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20191127002507 CA Practitioner - Nurse Practitioner 3274714407

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ARNP9221773FLMDFamily Nurse Practitioner
5010300NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Major Hospital 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1262476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776297600000",
    "number": "1851621536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5935 PROVIDENCE GLEN RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282703722",
            "telephone_number": "980-457-5645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5935 PROVIDENCE GLEN RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282703722",
            "telephone_number": "980-457-5645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANDELARIO",
        "first_name": "VICTOR",
        "middle_name": "IGNACIO",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-01-03",
        "last_updated": "2026-04-16",
        "certification_date": "2026-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9221773",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5010300",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95005933",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004180600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VICTOR",
            "last_name": "KLINGSHIRN",
            "credential": "ARNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.