Kandie Ann Forest, N.P.

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

71001824 Issued in IN

Practice address

2349 Lake Ave
Suite 201
Plymouth, IN 46563-7835

Phone

(574) 941-2977

Fax

(574) 941-2978

NPI assigned

Apr 2, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: kforest1154394@direct.trinity-health.org

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.

• Mohci Urgent Care LLC

  • Family Medicine Physician
  • Indianapolis, IN
  • NPI 1457398018
  NPD (past)

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1871614594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2349 LAKE AVE STE 99",
            "city": "PLYMOUTH",
            "state": "IN",
            "postal_code": "465637837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2349 LAKE AVE",
            "address_2": "SUITE 201",
            "city": "PLYMOUTH",
            "state": "IN",
            "postal_code": "465637835",
            "telephone_number": "574-941-2977",
            "fax_number": "574-941-2978"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "616 E 13th St",
            "address_purpose": "LOCATION",
            "city": "Winamac",
            "state": "IN",
            "postal_code": "469961117",
            "country_code": "US",
            "telephone_number": "574-948-5340",
            "fax_number": "574-948-5494",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FOREST",
        "first_name": "KANDIE",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-02",
        "last_updated": "2023-11-27",
        "certification_date": "2023-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71001824A",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71001824",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200502780",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• FH Decks and Landscaping Inc
• Amy Marie Fish, NP
• Todd Fisher
• FMS Nephrology Partners North Central Indiana Dialysis Centers, LLC
• Amy Foerg, MSN, RN, PMHNP-BC
• Eric W Foster, LMHC
• Daniel Adam Franz, LMHC
• Nanette Arone Fredericks, LCSW
• Kathleen C Freet, MSW, LCSW
• Joseph Fried, MSW, LCSW

• Family Nurse Practitioner in Plymouth, IN
• Providers in Plymouth, IN by specialty
• Family Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; 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.