Individual provider Active NPI

Candace H Wortham, CFNP

  • Primary Care Nurse Practitioner
  • Lagrange, GA
National Provider Identifier
1902842263
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
100010 Issued in GA
Practice address
303 Smith Street
Clark-Holder Clinic, P.a.
Lagrange, GA 30240
Phone
(706) 882-8831
Fax
(706) 812-4091
NPI assigned
Jun 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 100010 GA
Critical Care Medicine Nurse Practitioner 363LC0200X 100010 GA
Primary Care Nurse Practitioner 363LP2300X 100010 GA Primary

Addresses

Primary practice location

303 Smith Street
Clark-Holder Clinic, P.a.
Lagrange, GA 30240

Mailing address

303 Smith Street
Clark-Holder Clinic, P.a.
Lagrange, GA 30240
Phone (706) 882-8831

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20050810000908 GA Practitioner - Nurse Practitioner 7517996457 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellstar Medical Group LLCGroup PAC ID 6709065402, 3,059 clinicians

Practice addresses (Care Compare)

1551 Doctors Dr
Lagrange, GA 30240-4139
Phone (706) 880-7222

5150 Stilesboro N W Rd
Suite 220
Kennesaw, GA 30152-7742
Phone (770) 424-8222

Merit-based Incentive Payment System (MIPS)

Final score
93.93 of 100Reported as apm
Quality
82.14
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
100010GAMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstar Medical Group, LLC Current Accepting new patients
Wellstar Medical Group, LLC CurrentSince May 7, 2017 Accepting new patients

Locations

454 Lagrange St
Greenville, GA 30222
Phone (706) 672-4251

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

5150 Stilesboro Rd NW
Ste 120
Kennesaw, GA 30152
Phone (678) 354-0230

1514 Vernon Rd
Lagrange, GA 30240
Phone (706) 812-2369

1551 Doctors Dr
Lagrange, GA 30240
Phone (706) 845-7711

Interoperability endpoints

  • Direct secure messaging: cwortham134952@directwellstar.org

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1902842263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 SMITH STREET",
            "address_2": "CLARK-HOLDER CLINIC, P.A.",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "30240",
            "telephone_number": "706-882-8831",
            "fax_number": "706-812-4091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 SMITH STREET",
            "address_2": "CLARK-HOLDER CLINIC, P.A.",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "30240",
            "telephone_number": "706-882-8831",
            "fax_number": "706-812-4091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WORTHAM",
        "first_name": "CANDACE",
        "middle_name": "H",
        "credential": "CFNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-22",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "100010",
            "primary": false
        },
        {
            "code": "363LC0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Critical Care Medicine",
            "state": "GA",
            "license": "100010",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "GA",
            "license": "100010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lagrange, GA

Sources for this page

Verify at the official NPI Registry.