Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1487703153 Individual Practitioner Female Practitioner

Dr. Candra Lanette Mack , MD

Pediatrics • Covington, GA

Professional Overview & Biography Verified Profile Summary

Dr. Candra Mack, MD is a registered healthcare professional specializing in Pediatrics in Covington, GA. Practice services are available at 4152 BAKER STREET, NE under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

4152 Baker Street, Ne

Covington, GA 300141404

Telephone 7707881077
Fax 7708059329
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Pediatrics in Covington, GA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 21.2 Yrs
Regional Practice Density
9 Specialists

Practicing in Covington, GA (2326 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Pediatrics Primary Specialty

NUCC Taxonomy Code: 208000000X

State License GA 61000

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Pediatrics

NUCC Taxonomy Code: 208000000X

State License FL TRN8908

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
510091718A (GA)
Commercial Insurance / Payer ID Medical License
061000 (GA)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

7 Associated Practitioners
Dr. Samantha Tait , DNP, CPNP-PC

Nurse Practitioner - Pediatrics

NPI 1093604985

Doctor of Nursing Practice, CPNPPC

NPI 1528144839

Doctor of Medicine (M.D.)

Daphnee Stewart , CPNP-PC

Nurse Practitioner - Pediatrics

NPI 1770993560

CPNPPC

Joy Jackson , FNP-C

Nurse Practitioner - Family

NPI 1780023283

Family Nurse Practitioner (Certified)

NPI 1801954458

Doctor of Medicine (M.D.)

Dr. Cierra Lacour , DNP, CPNP-PC

Nurse Practitioner - Pediatrics

NPI 1922921287

Doctor of Nursing Practice, CPNPPC

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) March 07, 2023

Pediatrics (License #TRN8908 in FL)

NPI Profile Active March 19, 2014

NPI status registered as active in NPPES database

📍
Updated Practice Location March 19, 2014

Registered at 4152 BAKER STREET, NE, COVINGTON, GA 300141404 (Tel: 7707881077)

📍
Updated Business Mailing Address March 19, 2014

Registered at 4152 BAKER STREET, NE, COVINGTON, GA 300141404 (Tel: 7707881077)

👤
Provider Name / Credentials Updated March 19, 2014

Recorded as CANDRA MACK, M.D.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) March 19, 2014

Pediatrics (License #61000 in GA)

🟢
Initial NPI Registration & Enumeration January 10, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1487703153
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: January 10, 2007
Last Update: March 07, 2023
Sole Proprietor: No

Mailing Address

4152 Baker Street, Ne

Covington, GA 300141404

Phone: 7707881077

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.