CARRISSA CANDLER MD PLLC (NPI# 1588912034) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588912034 |
| Entity Type | Organization |
| Organization Name | CARRISSA CANDLER MD PLLC |
| Other Organization Name | CARISSA CANDLER, MD |
| Practice Address |
120 N Bryant Ave Ste A6 Edmond OK 73034-6300 |
| Practice Telephone | 4059360504 |
| Practice Fax Number | 4059360561 |
| Mailing Telephone | 4059360504 |
| Mailing Fax Number | 4059360561 |
| Enumeration Date | 2012-08-15 |
| Last Update Date | 2012-08-15 |
| Authorized Official Name | CARRISSA CANDLER (MEDICAL DOCTOR) |
| Authorized Official Telephone | 4059360504 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207T00000X | Neurological Surgery | 20774 | OK | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | 200166550A | 05 |
| Other Name | Type Code |
|---|---|
| Carissa Candler, MD | Doing Business As Name - Organization |
| Street Address |
120 N BRYANT AVE STE A6 |
| City | EDMOND |
| State | OK |
| Zip Code | 73034-6300 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306447172 | Saints Medical Group, LLC | Family Medicine | 2749 Progressive Dr, Suite B, Edmond, OK 73034 | 2020-11-06 |
| 1194339861 | Susan Haesook Kim | Pharmacist | 1400 2nd St, Edmod, Edmond, OK 73034 | 2020-09-01 |
| 1821616038 | Aaron Michael Gowens | Specialist/Technologist | 015 Wantland Hall 100 University Dr., Edmond, OK 73034 | 2020-07-14 |
| 1043834849 | Paddington Place Lcc | Intermediate Care Facility, Mental Illness | 3225 French Park Drive, Suite 6, Edmond, OK 73034 | 2020-06-08 |
| 1083254932 | Purpose Healthcare Inc | Psychologist | 301 South Blvd, Suite 117, Edmond, OK 73034 | 2020-01-08 |
| 1740773662 | Healthcare Express, LLP | Family Medicine | 2300 E 2nd St, Edmond, OK 73034 | 2018-06-14 |
| 1427555713 | Sara Nicole Smith | Specialist/Technologist | 100 N University Drive, Attn: Athletic Training Room, Edmond, OK 73034 | 2018-04-12 |
| 1619475084 | Carissa Leigh Brackelsberg | Chiropractor | 3709 E 2nd St, Edmond, OK 73034 | 2018-01-31 |
| 1760996177 | Laurel Michelle Glendening | Physical Therapist | 3531 River Wood Lane, Edmond, OK 73034 | 2017-11-21 |
| 1134643380 | Keith S Quinn | Dentist | 3008 Peaceful Ln, Edmond, OK 73034 | 2017-07-31 |
| Find all providers in zip 73034 | ||||
| Taxonomy Code | 207T00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Neurological Surgery |
| A neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Neurological Surgery, 2007. http://www.abns.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Neurological Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518396860 | Kevin Teal, M.d., P.C. | Neurological Surgery | 4833 Integris Pkwy, Ste 200, Edmond, OK 73034-8864 | 2013-11-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114560554 | Secure Interpretation, LLC | Neurological Surgery | 5561 South Lewis Ave, Tulsa, OK 74105 | 2019-10-17 |
| 1710540257 | David M Mckalip Md Pllc | Neurological Surgery | 5108 W Gore Blvd Ste 2b, Lawton, OK 73505-6025 | 2019-04-19 |
| 1215356589 | Zoya Alexandrovna Voronovich | Neurological Surgery | 1000 N Lincoln Blvd Ste 300, Oklahoma City, OK 73104-3252 | 2014-04-15 |
| 1396034047 | Saints Medical Group, LLC | Neurological Surgery | 800 Nw 9th St Ste 201, Oklahoma City, OK 73106-7253 | 2011-04-04 |
| 1669784351 | Thomas D. Reeder II, D.o., P.C. | Neurological Surgery | 2212 Nw 47th St, Oklahoma City, OK 73112-8848 | 2010-07-09 |
| 1215252440 | Joanna Elizabeth Gernsback | Neurological Surgery | 1000 N Lincoln Blvd # 4000, Oklahoma City, OK 73104-3252 | 2010-03-31 |
| 1811222094 | John Albert Coates | Neurological Surgery | 6416 S Quebec Ave, Tulsa, OK 74136-1611 | 2009-10-06 |
| 1003050493 | Tyler Sean Auschwitz | Neurological Surgery | 2000 South Wheeling, Ste 200, St. Johns Neuroscience Institute, Tulsa, OK 74104 | 2009-04-29 |
| 1881867547 | Rongsheng Cai | Neurological Surgery | 6151 S Yale Ave Ste 2403, Tulsa, OK 74136-1907 | 2008-04-02 |
| 1679759625 | Qualls E Stevens | Neurological Surgery | 1342 S Douglas Blvd, Suite A, Midwest City, OK 73130-5215 | 2008-01-20 |
| Find all providers with the same taxonomy | ||||
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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.