Individual provider Active NPI

Candace Rose Musgrove, NP

  • Family Nurse Practitioner
  • Douglas, GA
National Provider Identifier
1982239141
Registry record updated Mar 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
217571 Issued in GA
Practice address
1101 Ocilla Rd
Douglas, GA 31533-2262
Phone
(912) 384-1900
NPI assigned
Mar 9, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 217571 GA Primary

Addresses

Primary practice location

1101 Ocilla Rd
Douglas, GA 31533-2262

Mailing address

67 Kingsridge Dr
Broxton, GA 31519-6543
Phone (912) 592-5563

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address candace.musgrove@coffeeregional.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20200728004039 GA Practitioner - Nurse Practitioner 5395160006 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
CRH Physician Practices, LLCGroup PAC ID 5193727964, 38 clinicians

Practice addresses (Care Compare)

903 Ward St W
Suite B
Douglas, GA 31533-3536
Phone (912) 384-4111

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
217571GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
CRH Physician Practices, LLC CurrentSince May 1, 2020 Accepting new patients
CRH Physician Practices LLC Past Accepting new patients

Locations

1101 Ocilla Rd
Douglas, GA 31533
Phone (912) 383-5641

903 Ward St W
Ste B
Douglas, GA 31533
Phone (912) 384-4111

1508 Tebeau St
Waycross, GA 31501
Phone (912) 383-6575

Interoperability endpoints

  • Direct secure messaging: candace.musgrove.1@9964.direct.athenahealth.com

Organizations & group practices 2

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1583712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583798400000",
    "number": "1982239141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "67 KINGSRIDGE DR",
            "city": "BROXTON",
            "state": "GA",
            "postal_code": "315196543",
            "telephone_number": "912-592-5563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 OCILLA RD",
            "city": "DOUGLAS",
            "state": "GA",
            "postal_code": "315332262",
            "telephone_number": "912-384-1900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUSGROVE",
        "first_name": "CANDACE",
        "middle_name": "ROSE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-09",
        "last_updated": "2020-03-10",
        "certification_date": "2020-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "217571",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "candace.musgrove@coffeeregional.org",
            "affiliation": "N",
            "endpointDescription": "Work email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1101 Ocilla Rd",
            "city": "Douglas",
            "state": "GA",
            "country_code": "US",
            "postal_code": "315332262",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Douglas, GA

Sources for this page

Verify at the official NPI Registry.