Individual provider Active NPI

Candace Vera Deverell, CRNP

  • Family Nurse Practitioner
  • Charles City, IA
National Provider Identifier
1871005819
Registry record updated Mar 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP017967 Issued in PA
Practice address
1501 S Main St
Charles City, IA 50616-3440
Phone
(641) 228-5151
NPI assigned
Oct 31, 2017
Last updated
Mar 11, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2026

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 SP017967 PA Primary

Addresses

Primary practice location

1501 S Main St
Charles City, IA 50616-3440

Mailing address

1501 S Main St
Charles City, IA 50616-3440
Phone (641) 228-5151

Other identifiers 1

IdentifierTypeStateIssuer
14142792OtherCAQH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20240403003862 IA Practitioner - Nurse Practitioner 0547520132 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

800 11TH St
Charles City, IA 50616-3468
Phone (641) 257-1184

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP017967PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Floyd County Memorial Hospital Commission Current Accepting new patients
Floyd County Memorial Hospital Commission CurrentSince Mar 1, 2024 Accepting new patients
Floyd County Hosp Past Accepting new patients
Floyd County Memorial Hospital Commission Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

1501 S Main St
Ste 6
Charles City, IA 50616
Phone (641) 228-5151

800 11th St
Charles City, IA 50616
Phone (641) 228-6830

Organizations & group practices 5

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.

Hospital & facility affiliations 1

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": "1509408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773187200000",
    "number": "1871005819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 S MAIN ST",
            "city": "CHARLES CITY",
            "state": "IA",
            "postal_code": "506163440",
            "telephone_number": "641-228-5151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 S MAIN ST",
            "city": "CHARLES CITY",
            "state": "IA",
            "postal_code": "506163440",
            "telephone_number": "641-228-5151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVERELL",
        "first_name": "CANDACE",
        "middle_name": "VERA",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-31",
        "last_updated": "2026-03-11",
        "certification_date": "2026-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP017967",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "14142792",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charles City, IA

Sources for this page

Verify at the official NPI Registry.