Carrie Kincaid-Washington, D.P.M.

Primary specialty

PodiatristTaxonomy code 213E00000X

License

0103000808 Issued in VA

Practice address

119 Central Park
Petersburg, VA 23803-4551

Phone

(804) 322-3996

NPI assigned

Jul 7, 2006

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

William M. Scholl College of Podiatric Medicine, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pedirite Medical VA PLLCGroup PAC ID 3072916907, 4 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Pedirite Medical VA PLLC

  • General Practice Physician
  • Colonial Heights, VA
  • NPI 1851962229
  Medicare reassignment Care Compare group NPD
• Southside Family Practice P.C.

  • Family Medicine Physician
  • Petersburg, VA
  • NPI 1780700765
  NPD (past)
• Premier Podiatry of Virginia LLC

  • Podiatrist
  • Owings Mills, MD
  • NPI 1356430078
  NPD (past)
• Professional Management Services, LLC

  • Durable Medical Equipment & Medical Supplies
  • Baltimore, MD
  • NPI 1144653288
  NPD (past)
• Professional Management Services, LLC

  • Podiatrist
  • Baltimore, MD
  • NPI 1699731810
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643932800000",
    "number": "1104858323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 CENTRAL PARK",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238034551",
            "telephone_number": "804-322-3996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 CENTRAL PARK",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238034551",
            "telephone_number": "804-322-3996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINCAID-WASHINGTON",
        "first_name": "CARRIE",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-07",
        "last_updated": "2022-02-04",
        "certification_date": "2022-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "VA",
            "license": "0103000808",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9330429",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shamas Chungez Kiani, M.D.
• Jackson Allen Kicklighter, PHARMD, MHA, BCMTMS
• Kim Dawkins
• Suel Peter Kim, MD
• Kimberly K Jones - Karisma Consulting
• Kindred Community Cares Inc.
• Kindred Support Services LLC
• King & Queens Transport LLC
• Annette Q King, MS, RDN
• Darnella King

• Podiatrist in Petersburg, VA
• Providers in Petersburg, VA by specialty
• Podiatrist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.