Kacey Roach, RD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

DI60727139 Issued in WA

Practice address

2608 Kwina Rd
Bellingham, WA 98226-9291

Phone

(360) 312-2100

NPI assigned

Jan 25, 2017

Last updated

Aug 13, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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 WA

Enrollment records 1

Specialty

Registered Dietitian Or Nutrition Professional

Education

Adio/Pennsylvania Institute of Straight Chiropractic, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lummi Indian Business CouncilGroup PAC ID 5395738231, 26 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lummi Indian Business Council

  dba Lummi Nation Health Center

  • Clinic/Center
  • Bellingham, WA
  • NPI 1669592374
  Medicare reassignment Care Compare group NPD
• Puget Sound Kidney Centers

  dba PSKC Anacortes

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Anacortes, WA
  • NPI 1073939062
  Medicare reassignment NPD
• Lummi Indian Business Council

  dba Lummi Nation Health Center

  • Counselor
  • Bellingham, WA
  • NPI 1225158769
  NPD
• Puget Sound Kidney Centers

  dba PSKC - Whidbey Island

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Oak Harbor, WA
  • NPI 1295855013
  NPD
• Puget Sound Kidney Centers

  dba Puget Sound Kidney Center Richmond Beach

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Shoreline, WA
  • NPI 1558149807
  NPD
• Puget Sound Kidney Centers

  dba PSKC - Smokey Point

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Arlington, WA
  • NPI 1386764009
  NPD (past)
• Puget Sound Surgical Clinic Inc

  • Surgery Physician
  • Shoreline, WA
  • NPI 1699785527
  NPD (past)
• Renovo Medical Group

  • Adult Medicine Physician
  • Shoreline, WA
  • NPI 1275931982
  NPD (past)

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

{
    "created_epoch": "1485302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723507200000",
    "number": "1295272573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2608 KWINA RD",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982269291",
            "telephone_number": "360-312-2100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2608 KWINA RD",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982269291",
            "telephone_number": "360-312-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROACH",
        "first_name": "KACEY",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-25",
        "last_updated": "2024-08-13",
        "certification_date": "2024-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "WA",
            "license": "DI60727139",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "DI60727139",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Registered Dietitian in Bellingham, WA
• Providers in Bellingham, WA by specialty
• Registered Dietitian in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.