MRS. CANDACE RENEE WOOTEN-REED (NPI# 1750529764) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750529764 |
| Entity Type | Individual |
| Full Name | MRS. CANDACE RENEE WOOTEN-REED |
| Credential | PA-C |
| Practice Address |
10210 Couloak Dr Suite E Charlotte NC 28216-7679 |
| Mailing Address |
2745 Dekalb Medical Parkway Ste 200 Lithonia GA 30058 |
| Practice Telephone | 7048012000 |
| Practice Fax Number | 7048012001 |
| Mailing Telephone | 4044463870 |
| Mailing Fax Number | 4044463875 |
| Enumeration Date | 2009-01-29 |
| Last Update Date | 2018-08-03 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
007386 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
0010-03360 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
5601005386 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 8102163 | 05 |
| Street Address |
10210 COULOAK DR SUITE E |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28216-7679 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457350258 | Jonathan Robert Baltzell | Physician Assistant | 10210 Couloak Dr, Suite E, Charlotte, NC 28216-7679 | 2005-07-14 |
| 1962786640 | Audia Ellis | Nurse Practitioner | 10210 Couloak Dr, Ste E, Charlotte, NC 28216-7679 | 2011-09-29 |
| 1376849950 | Gary Barrett | Physician Assistant | 10210 Couloak Dr, Ste E, Charlotte, NC 28216-7679 | 2011-01-31 |
| 1053648683 | Ashley Vaughn | Nurse Practitioner | 10210 Couloak Dr, Suite E, Charlotte, NC 28216-7679 | 2009-11-03 |
| 1942442397 | Julie Lacoursiere | Physician Assistant | 10210 Couloak Dr, Ste E, Charlotte, NC 28216-7679 | 2009-04-01 |
| 1760660575 | April Parker | Physician Assistant | 10210 Couloak Dr, Ste E, Charlotte, NC 28216-7679 | 2008-02-04 |
| 1992825368 | Sheila Brun Chervil | Physician Assistant | 10210 Couloak Dr, Suite E, Charlotte, NC 28216-7679 | 2007-03-30 |
| 1366522369 | Carolinas Physicians Network Inc | Internal Medicine | 10210 Couloak Dr, Ste E, Charlotte, NC 28216-7679 | 2006-10-16 |
| 1053413773 | Dana Wolfe | Nurse Practitioner | 10210 Couloak Dr, Ste E, Charlotte, NC 28216-7679 | 2006-09-02 |
| 1306955463 | Emily E Lorenzo | Family Medicine | 10210 Couloak Dr, Suite E, Charlotte, NC 28216-7679 | 2006-08-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942837331 | Transit Consortium of South Carolina, LLC | Non-emergency Medical Transport (VAN) | 5025 Roundstone Way, Suite 103, Charlotte, NC 28216 | 2020-03-25 |
| 1811538796 | Strengthening Families Within Communities LLC | Community/Behavioral Health | 4135 Bryan Furr Drive, Charlotte, NC 28216 | 2019-10-02 |
| 1841705159 | Karen Sue Rhea | Registered Nurse | 4004 Nicole Eileen Lane, Charlotte, ND 28216 | 2017-12-08 |
| 1992225890 | Be Free Counseling, Pllc | Social Worker | 7800 Bridle Court, Charlotte, NC 28216 | 2017-06-21 |
| 1013466416 | Roha Solutions, Inc | Community Based Residential Treatment Facility, Mental Illness | 1529 Jennings St, Charlotte, NC 28216 | 2016-09-26 |
| 1336595826 | North Carolina Neurodiagnostics, LLC | Clinic/Center | 10130 Perimeter Pwky, Ste. 200, Office 250, Charlotte, NC 28216 | 2016-05-13 |
| 1346600699 | Elizabeth Ayodele Agiri | Registered Nurse | 9404 Perimeter Station Dr, Apt. 108, Charlotte, NC 28216 | 2016-02-29 |
| 1922479179 | Prashant Patel | Pharmacist | 9820 Callibridge Court, Charlotte, NC 28216 | 2015-10-14 |
| 1205226685 | Sarah Baker | Social Worker | 10506 Grobie Way Apt 104, Charlotte, NC 28216 | 2015-01-23 |
| 1578967089 | The Moon Home | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 4548 Hyperion Court, Charlotte, NC 28216 | 2014-10-13 |
| Find all providers in zip 28216 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982213765 | Michaela Lynne Mcbride | Physician Assistant | 9541 Kings Parade Blvd Unit 107, Charlotte, NC 28273-5819 | 2020-07-28 |
| 1982212072 | Alexandria Bower-nelson | Physician Assistant | 1302 Porter Drive, Charlotte, MI 48813 | 2020-07-15 |
| 1417506791 | Lauren Moir | Physician Assistant | 2700 Coltsgate Rd Ste 106, Charlotte, NC 28211-3573 | 2019-09-09 |
| 1609306778 | Mackenzie Cashman Precht | Physician Assistant | 2225 E W T Harris Blvd Unit B, Charlotte, NC 28213 | 2017-06-12 |
| 1285172981 | Melanie Reyer | Physician Assistant | 5005 Morrowick Rd, Charlotte, NC 28226-7366 | 2017-02-02 |
| 1255877627 | Taylor King | Physician Assistant | 730 Hawthorne Ln Apt 443, Charlotte, NC 28204-2182 | 2017-01-10 |
| 1831579242 | Lindsey Chaney Taylor | Physician Assistant | 1900 Randolph Road, Suite 900, Charlotte, NC 28207-1122 | 2015-06-02 |
| 1306232079 | Rebecca Lee Strunk-lail | Physician Assistant | 1211 N. Community House Rd, Charlotte, NC 28277 | 2015-04-09 |
| 1194117432 | Harlee Palmer | Physician Assistant | 10502 Park Rd Suite 100, Charlotte, NC 28210-8479 | 2015-02-24 |
| 1154669364 | Laura A Justen | Physician Assistant | 1025 Morehead Medical Dr Ste 225, Charlotte, NC 28204-2974 | 2013-01-23 |
| Find all providers in CHARLOTTE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.