Candice King, NP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

F306987-1 Issued in NY

Practice address

625 Montauk Hwy
Center Moriches, NY 11934

Phone

(631) 878-7134

Fax

(631) 878-5118

NPI assigned

Aug 5, 2014

Last updated

Aug 5, 2014By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Candice Gimenez Former name

Medicare fee-for-service enrollment

Enrolled in NY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• South Bay Medical Care P.C.

  • Emergency Medicine Physician
  • Center Moriches, NY
  • NPI 1366569352
  NPD

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

{
    "created_epoch": "1407196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407196800000",
    "number": "1871902767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 MONTAUK HWY",
            "city": "CENTER MORICHES",
            "state": "NY",
            "postal_code": "11934",
            "telephone_number": "631-878-7134",
            "fax_number": "631-878-5118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 MONTAUK HWY",
            "city": "CENTER MORICHES",
            "state": "NY",
            "postal_code": "11934",
            "telephone_number": "631-878-7134",
            "fax_number": "631-878-5118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "CANDICE",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-05",
        "last_updated": "2014-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F306987-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CANDICE",
            "last_name": "GIMENEZ",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sophia L. Kary, PH.D.
• Madison Grace Kayel
• Danielle Kennedy
• Kenneth Gaul II, LLC
• King Kullen Pharmacies Corp (King Kullen Pharmacy)
• Barbara Koska, MS, CCC-SLP
• Maureen Mary Laclair, COTA
• Michael Lafauci, RPH
• Fran Lasker
• Anne Leogrande

• Adult Health Nurse Practitioner in Center Moriches, NY
• Providers in Center Moriches, NY by specialty
• Adult Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.