Candace C Waters, MSN, FNP-BC, CDE

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

459 Issued in SC

Practice address

124 Bettis Academy Rd
Graniteville, SC 29829-3107

Phone

(803) 392-3724

Fax

(803) 234-5593

NPI assigned

Sep 9, 2005

Sex

Female

Sole proprietor

No

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 SC

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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

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

{
    "created_epoch": "1126224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600819200000",
    "number": "1962496554",
    "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": "803-392-3724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 BETTIS ACADEMY RD",
            "city": "GRANITEVILLE",
            "state": "SC",
            "postal_code": "298293107",
            "telephone_number": "803-392-3724",
            "fax_number": "803-234-5593"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "309 West Ave",
            "address_purpose": "LOCATION",
            "city": "North Augusta",
            "state": "SC",
            "postal_code": "298413800",
            "country_code": "US",
            "telephone_number": "803-279-1412",
            "fax_number": "803-279-2858",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WATERS",
        "first_name": "CANDACE",
        "middle_name": "C",
        "name_prefix": "Mrs.",
        "credential": "MSN, FNP-BC, CDE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-09",
        "last_updated": "2020-09-23",
        "certification_date": "2020-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "459",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Graniteville, SC
• Family Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2020; 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.

Verify at the official NPI Registry.