Nicole Marie Canada, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME131703 Issued in FL

Practice address

250 2ND St E Ste 4G
Bradenton, FL 34208-1028

Phone

(941) 708-8199

Fax

(941) 708-8194

NPI assigned

Oct 27, 2005

Last updated

Mar 22, 2024By 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

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lakeland Regional Health Systems IncGroup PAC ID 8325952914, 513 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lakeland Regional Medical Center Hospital, Lakeland, FL, CCN 100157

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ncanada53151@lrhs.direct-ci.com

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.

• Lakeland Regional Health Systems, Inc.

  • Multi-Specialty Clinic/Center
  • Lakeland, FL
  • NPI 1497748743
  Medicare reassignment Care Compare group NPD
• Manatee Memorial Hospital L P

  dba Manatee Memorial Hospital

  • Other Specialist/Technologist
  • Bradenton, FL
  • NPI 1770505687
  Medicare reassignment NPD
• Manatee Memorial Hospital L P

  dba Manatee Diagnostic Center Pointe West

  • Body Imaging Physician
  • Bradenton, FL
  • NPI 1437519436
  NPD
• Manatee Memorial Hospital L P

  dba Manatee Diagnostic Center

  • Radiology Clinic/Center
  • Bradenton, FL
  • NPI 1558020552
  NPD
• Lakeland Regional Medical Center, Inc.

  dba Lakeland Regional Medical Center

  • General Acute Care Hospital
  • Lakeland, FL
  • NPI 1144228446
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Lakeland Regional Medical Center, Inc.

  dba Lakeland Regional Medical Center

  • General Acute Care Hospital
  • Lakeland, FL
  • NPI 1144228446
  Care Compare affiliation

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

{
    "created_epoch": "1130371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711065600000",
    "number": "1912997180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "367 S. GULPH RD",
            "address_2": "ATT IPM CREDENTIALING",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "194063121",
            "telephone_number": "941-708-8199",
            "fax_number": "941-708-8194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 2ND ST E STE 4G",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342081028",
            "telephone_number": "941-708-8199",
            "fax_number": "941-708-8194"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9135 58th Dr E",
            "address_purpose": "LOCATION",
            "city": "Bradenton",
            "state": "FL",
            "postal_code": "342029188",
            "country_code": "US",
            "telephone_number": "941-216-6200",
            "fax_number": "941-216-6201",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9135 58th Dr E",
            "address_purpose": "LOCATION",
            "city": "Bradenton",
            "state": "FL",
            "postal_code": "342029188",
            "country_code": "US",
            "telephone_number": "941-216-6200",
            "fax_number": "941-216-6201",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "300 Parkview Pl",
            "address_purpose": "LOCATION",
            "city": "Lakeland",
            "state": "FL",
            "postal_code": "338054550",
            "country_code": "US",
            "telephone_number": "863-687-1300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CANADA",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-10-27",
        "last_updated": "2024-03-22",
        "certification_date": "2024-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME131703",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Linda J Campbell, RDN
• Alyssa Christine Campos, MD
• Rosabelle Campos, MD
• Adriana Maria Camunas, OTR
• Felicia A Canada, MD
• Jennifer Canale
• Gail Ann Canario, LMHC
• Ryan Canavan, DC
• Lenore Felice Canavarros, LCSW
• Kendra Channel Cannon, REGISTERED NURSE

• Family Medicine Physician in Bradenton, FL
• Providers in Bradenton, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.