Active NPI
Kacy J Herron, MD
- Family Medicine Physician
- Seattle, WA
National Provider Identifier
1114306644
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MD60828698
- Practice address
- 1401 Madison St Ste 100
Seattle, WA 98104 - Phone
- (206) 386-6111
- Fax
- (206) 386-6113
- NPI assigned
- May 29, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MRM-1480 | ID | |
| Family Medicine Physician | 207Q00000X | MD60828698 | WA | Primary |
Addresses
Primary practice location
1401 Madison St Ste 100
Seattle, WA 98104
Mailing address
PO Box 25608
Salt Lake City, UT 84125-0608
Other practice location 1
777 N Raymond St
Boise, ID 83704-9251
Phone (208) 514-2500
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AK
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- University of Washington School of Medicine, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1801 Salmon Creek LN
Juneau, AK 99801-7864
Phone (907) 586-2434
Hospital & facility affiliations
- Bartlett Regional Hospital
- Southeast Alaska Regional Health Consortium
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
| Removal or shaving of skin growth | 1-10 |
| Skin biopsy | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MRM-1480 | ID | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Valley Medical Care PC | Family Medicine | Current | Accepting new patients |
Locations
1801 Salmon Creek Ln
Juneau, AK 99801
Phone (907) 586-2434
Organizations & group practices 1
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.
-
- Family Medicine Physician
- Juneau, AK
- NPI 1851506836
Hospital & facility affiliations 36
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Juneau, AK
- NPI 1891849261
-
- Clinic/Center
- Tenakee Springs, AK
- NPI 1477721280
Hospital
-
- Nursing Facility/Intermediate Care Facility
- Juneau, AK
- NPI 1932312485
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1432857600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1533600000000",
"number": "1114306644",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 25608",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841250608"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1401 MADISON ST STE 100",
"city": "SEATTLE",
"state": "WA",
"postal_code": "98104",
"telephone_number": "206-386-6111",
"fax_number": "206-386-6113"
}
],
"practiceLocations": [
{
"address_1": "777 N Raymond St",
"address_purpose": "LOCATION",
"city": "Boise",
"state": "ID",
"postal_code": "837049251",
"country_code": "US",
"telephone_number": "208-514-2500",
"fax_number": "208-375-2217",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HERRON",
"first_name": "KACY",
"middle_name": "J",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-05-29",
"last_updated": "2018-08-07",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "ID",
"license": "MRM-1480",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WA",
"license": "MD60828698",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2018; 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.