Individual provider Active NPI

Candace Dawn Hurst, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Indianapolis, IN
National Provider Identifier
1952015000
Registry record updated Jan 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
71013453A Issued in IN
Practice address
5638 Professional Cir
Indianapolis, IN 46241
Phone
(888) 714-1927
NPI assigned
Jan 12, 2023
Last updated
Jan 12, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 71013453A IN Primary

Addresses

Primary practice location

5638 Professional Cir
Indianapolis, IN 46241

Mailing address

5657 W Baywood Dr
New Palestine, IN 46163
Phone (317) 410-4161

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Cummins Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20230207002495 IN Practitioner - Nurse Practitioner 6002288768 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cummins Behavioral Health Systems IncorporatedGroup PAC ID 1850296302, 18 clinicians

Practice addresses (Care Compare)

1540 Darlington Ave
Crawfordsville, IN 47933-2009
Phone (888) 714-1927

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
71013453AINMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cummins Behavioral Health Systems, Incorporated CurrentSince Nov 5, 2022 Accepting new patients

Locations

5101 E US Highway 36
Ste 100
Avon, IN 46123
Phone (317) 745-9555

6655 E US Highway 36
Avon, IN 46123
Phone (317) 272-3330

1540 Darlington Ave
Crawfordsville, IN 47933

308 Medic Way
Greencastle, IN 46135
Phone (317) 653-2669

5638 Professional Cir
Indianapolis, IN 46241
Phone (317) 247-8900

940 Lasley Dr
Lebanon, IN 46052
Phone (765) 482-7421

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1673481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673481600000",
    "number": "1952015000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5657 W BAYWOOD DR",
            "city": "NEW PALESTINE",
            "state": "IN",
            "postal_code": "46163",
            "telephone_number": "317-410-4161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5638 PROFESSIONAL CIR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "46241",
            "telephone_number": "888-714-1927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HURST",
        "first_name": "CANDACE",
        "middle_name": "DAWN",
        "name_prefix": "Mrs.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-12",
        "last_updated": "2023-01-12",
        "certification_date": "2022-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IN",
            "license": "71013453A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Cummins",
            "affiliation": "N",
            "endpointDescription": "Outpatient Community Mental Health Services",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "5638 Professional Cir",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "46241",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.