Active NPI
Candy C Marshall, CFNP
- Nurse Practitioner
- Canyon, TX
National Provider Identifier
1912920844
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 517366
- Practice address
- 2620 Russell Long Blvd
Canyon, TX 79016 - Phone
- (806) 651-3287
- Fax
- (806) 651-3289
- NPI assigned
- Jul 25, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 517366 | TX | Primary |
Addresses
Primary practice location
2620 Russell Long Blvd
Canyon, TX 79016
Mailing address
2620 Russell Long Blvd
Canyon, TX 79016
Phone (806) 651-3287
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8Y8342 | Other | TX | BCBS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 517366 | TX | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| FMC Clinics, P.a. | Past | Accepting new patients |
Organizations & group practices 1
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 Medicine Physician
- Amarillo, TX
- NPI 1578756771
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153785600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1228348800000",
"number": "1912920844",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2620 RUSSELL LONG BLVD",
"city": "CANYON",
"state": "TX",
"postal_code": "79016",
"telephone_number": "806-651-3287",
"fax_number": "806-651-3289"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2620 RUSSELL LONG BLVD",
"city": "CANYON",
"state": "TX",
"postal_code": "79016",
"telephone_number": "806-651-3287",
"fax_number": "806-651-3289"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARSHALL",
"first_name": "CANDY",
"middle_name": "C",
"credential": "CFNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-25",
"last_updated": "2008-12-04",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "TX",
"license": "517366",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "8Y8342",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Canyon, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.