Active NPI
Candice Watts
- Licensed Practical Nurse
- Detroit, MI
National Provider Identifier
1992543862
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 4703117321
- Practice address
- 15368 Prevost St
Detroit, MI 48227-1961 - Phone
- (248) 832-1736
- NPI assigned
- Jul 16, 2024
- 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 |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 4703117321 | MI | Primary |
Addresses
Primary practice location
15368 Prevost St
Detroit, MI 48227-1961
Mailing address
15368 Prevost St
Detroit, MI 48227-1961
Phone (248) 832-1736
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4703117321 | MI | MD | Licensed Practical Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Delicare LLC | Licensed Practical Nurse | Current | Accepting new patients |
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1721088000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721088000000",
"number": "1992543862",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15368 PREVOST ST",
"city": "DETROIT",
"state": "MI",
"postal_code": "482271961",
"telephone_number": "248-832-1736"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15368 PREVOST ST",
"city": "DETROIT",
"state": "MI",
"postal_code": "482271961",
"telephone_number": "248-832-1736"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATTS",
"first_name": "CANDICE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-07-16",
"last_updated": "2024-07-16",
"certification_date": "2024-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "MI",
"license": "4703117321",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.