Individual provider Active NPI

Candace Tenise McMillon-Dantley, D.C.

  • Chiropractor
  • Quincy, FL
National Provider Identifier
1861796138
Registry record updated Apr 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH 10197 Issued in FL
Practice address
1249 Strong Rd
Quincy, FL 32351-5248
Phone
(850) 298-6082
Fax
(850) 627-2786
NPI assigned
Dec 30, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH 10197 FL Primary

Addresses

Primary practice location

1249 Strong Rd
Quincy, FL 32351-5248

Mailing address

2804 Remington Green Cir Ste 2
Tallahassee, FL 32308-1550
Phone (850) 385-4494

Other identifiers 1

IdentifierTypeStateIssuer
004415200MedicaidFL

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

NPI Registry JSON

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

{
    "created_epoch": "1293667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492473600000",
    "number": "1861796138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2804 REMINGTON GREEN CIR STE 2",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323081550",
            "telephone_number": "850-385-4494",
            "fax_number": "850-298-6054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1249 STRONG RD",
            "city": "QUINCY",
            "state": "FL",
            "postal_code": "323515248",
            "telephone_number": "850-298-6082",
            "fax_number": "850-627-2786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMILLON-DANTLEY",
        "first_name": "CANDACE",
        "middle_name": "TENISE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-30",
        "last_updated": "2017-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH 10197",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004415200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Quincy, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2017; 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.