Active NPI
Candace Nichole Lee, NP
- Nurse Practitioner
- Austin, TX
National Provider Identifier
1962088443
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 1033102
- Practice address
- 1717 W 6TH St
Austin, TX 78703-4773 - Phone
- (512) 806-3535
- NPI assigned
- Mar 23, 2021
- Sex
- Female
- Sole proprietor
- Yes
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 | 1033102 | TX | Primary |
Addresses
Primary practice location
1717 W 6TH St
Austin, TX 78703-4773
Mailing address
91 Red River St Apt 1214
Austin, TX 78701-4816
Phone (512) 542-1733
Other practice location 1
5525 Burnet Rd
Austin, TX 78756-1646
Phone (512) 371-0911
Other practice location 2
8721 Menchaca Rd
Austin, TX 78748-5308
Phone (737) 530-0911
Other practice location 3
2105 E Palm Valley Blvd
Round Rock, TX 78665-4538
Phone (512) 255-0911
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1616457600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1729641600000",
"number": "1962088443",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "91 RED RIVER ST APT 1214",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787014816",
"telephone_number": "512-542-1733"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1717 W 6TH ST",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787034773",
"telephone_number": "512-806-3535"
}
],
"practiceLocations": [
{
"address_1": "5525 Burnet Rd",
"address_purpose": "LOCATION",
"city": "Austin",
"state": "TX",
"postal_code": "787561646",
"country_code": "US",
"telephone_number": "512-371-0911",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "8721 Menchaca Rd",
"address_purpose": "LOCATION",
"city": "Austin",
"state": "TX",
"postal_code": "787485308",
"country_code": "US",
"telephone_number": "737-530-0911",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2105 E Palm Valley Blvd",
"address_purpose": "LOCATION",
"city": "Round Rock",
"state": "TX",
"postal_code": "786654538",
"country_code": "US",
"telephone_number": "512-255-0911",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LEE",
"first_name": "CANDACE",
"middle_name": "NICHOLE",
"credential": "NP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-03-23",
"last_updated": "2024-10-23",
"certification_date": "2024-10-23",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "TX",
"license": "1033102",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.