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CANDACE WILSON
NPI 1205456217
Family Medicine in Pine Bluff, AR

Active since April 20, 2020PECOS EnrolledAccepts Medicare Assignment
1601 W 40TH AVE STE 100, PINE BLUFF, AR 71603(870) 541-6000(870) 541-6010 Get Directions Write a Review

NPPES record last updated: October 18, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Oct 18, 2023, Apr 20, 2020 (2 updates tracked since 2020).

About Candace Wilson NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CANDACE WILSON (NPI 1205456217) is an individual family medicine provider in Pine Bluff, Arkansas, licensed in Arkansas (E-17243) and active in the NPI registry since April 2020. She is enrolled in Medicare PECOS and is a graduate of Other (2015).

NPPES Registry Identity

NPI1205456217
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameCANDACE WILSON
Location Address1601 W 40TH AVE STE 100Pine Bluff, AR 71603-6069
Mailing Address1601 W 40th Ave Ste 100Pine Bluff, AR 71603-6069 · (870) 541-6000 · Fax (870) 541-6010
Phone(870) 541-6000
Fax(870) 541-6010
Sole ProprietorNo
Medical School CMSOtherGraduated 2015
Enumeration DateApril 20, 2020
Last NPPES UpdateOctober 18, 20232 updates tracked since enumeration
NPPES CertifiedOctober 18, 2023
✔ NPI 1205456217 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in AR · E-17243
Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Also ListedEmergency MedicineTaxonomy 207P00000X · License E-17243 (AR)
1601 W 40TH AVE STE 100, Pine Bluff, AR 71603
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Candace Wilson is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9638529118
PECOS Enrollment IDI20231224000125
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 71603 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$79.72 typical visit price
range $51.36 – $157.74
Typical copayment $19.93 (range $12.84 – $39.43)
Most-billed visit code 99203
Established Patient
$91.63 typical visit price
range $16.16 – $128.77
Typical copayment $22.90 (range $4.04 – $32.19)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ROBERTA NARTEY MD
Student in an Organized Health Care Education/Training Program
1601 W 40TH AVE STE 100
PINE BLUFF, AR 71603
Jefferson County (870) 541-6010
SARVANI DEVI SARANYA PENTAKOTA
Student in an Organized Health Care Education/Training Program
1601 W 40TH AVE STE 100
PINE BLUFF, AR 71603
Jefferson County (870) 541-6010
AHMED YAHYA AMIN MBBS
Student in an Organized Health Care Education/Training Program
1601 W 40TH AVE STE 100
PINE BLUFF, AR 71603
Jefferson County (870) 541-6010
DR. SREE CHELLAPPAN MD
Family Medicine
1601 W 40TH AVE STE 100
PINE BLUFF, AR 71603
Jefferson County (870) 541-6000
MUSTAFA AL-MUSAWI
Student in an Organized Health Care Education/Training Program
1601 W 40TH AVE STE 100
PINE BLUFF, AR 71603
Jefferson County (870) 541-6010
MARIAN O OBI MD
Student in an Organized Health Care Education/Training Program
1601 W 40TH AVE STE 100
PINE BLUFF, AR 71603
Jefferson County (870) 541-6010
KHALED HASSAN MD
Family Medicine
1601 W 40TH AVE STE 100
PINE BLUFF, AR 71603
Jefferson County (870) 541-6010
KAMALELDEIN EINAR
Student in an Organized Health Care Education/Training Program
1601 W 40TH AVE STE 100
PINE BLUFF, AR 71603
Jefferson County (870) 541-6000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Candace Wilson's NPI number?

The NPI number for Candace Wilson is 1205456217. It was assigned to this individual provider in the NPPES registry on April 20, 2020.

Where is Candace Wilson located?

Candace Wilson practices at 1601 W 40th Ave Ste 100, Pine Bluff, AR 71603. The listed phone number is (870) 541-6000.

What is Candace Wilson's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Candace Wilson enrolled in Medicare?

Yes. Candace Wilson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Candace Wilson was last updated on October 18, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.