Candice Stapleton Purvis, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

006802 Issued in GA

Practice address

303 Harris Industrial Blvd Ste 3
Vidalia, GA 30474-8854

Phone

(912) 537-9355

NPI assigned

May 30, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Candice Grace Stapleton Former name

Medicare fee-for-service enrollment

Enrolled in GA

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

Physician Assistant

Practice roles

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.

• Family Healthcare Connections, PC

  • Internal Medicine Physician
  • Hazlehurst, GA
  • NPI 1083719710
  Medicare reassignment
• Tony Sparks, LLC Dba Hazlehurst Pediatrics

  • Pediatrics Physician
  • Hazlehurst, GA
  • NPI 1114743234
  NPD (past)

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

{
    "created_epoch": "1369872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558310400000",
    "number": "1891132817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 HARRIS INDUSTRIAL BLVD STE 3",
            "city": "VIDALIA",
            "state": "GA",
            "postal_code": "304748854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 HARRIS INDUSTRIAL BLVD STE 3",
            "city": "VIDALIA",
            "state": "GA",
            "postal_code": "304748854",
            "telephone_number": "912-537-9355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PURVIS",
        "first_name": "CANDICE",
        "middle_name": "STAPLETON",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-30",
        "last_updated": "2019-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "006802",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CANDICE",
            "last_name": "STAPLETON",
            "middle_name": "GRACE",
            "prefix": "MS.",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Premise Health of Georgia Medical PC (Dot Vidalia Family Health Center)
• Elisabeth Ann Proenza, FNP-C
• Richard M Proenza, PA-C
• Pruitthealth Home Health South Georgia, Inc (PruittHealth @ Home - Vidalia)
• Pruitthealth Home Health, Inc. (PruittHealth @ Home - Vidalia)
• Miranda Leigh Quick, COTA
• Courtney O Ragan, FNP
• Varalakshmi N Rao, M.D
• Christian Andrew Ray, PT, DPT, CSCS
• Sreekanth Reddy, MD

• Physician Assistant in Vidalia, GA
• Providers in Vidalia, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2019; 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.