Active NPI
Caroline Joy Roeder, D.O.
- Family Medicine Physician
- Anacortes, WA
National Provider Identifier
1396171500
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- OP60573566
- Practice address
- 1213 24TH St
#100
Anacortes, WA 98221 - Phone
- (360) 293-3101
- Fax
- (360) 588-1041
- NPI assigned
- Sep 19, 2013
- Last updated
- Sep 24, 2024
- 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 | OP60573566 | WA | Primary |
| Family Medicine Physician | 207Q00000X | OL60386634 | WA |
Addresses
Primary practice location
1213 24TH St
#100
Anacortes, WA 98221
Mailing address
3201 Commercial Ave Ste B
Anacortes, WA 98221-2761
Phone (360) 873-5318
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2000086 | Medicaid | WA |
Other names 1
- Caroline Joy Weinheimer
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Apr 22, 2024 through Apr 22, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OL60386634 | WA | MD | Family Medicine Physician |
| OP60573566 | WA | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1379548800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727136000000",
"number": "1396171500",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3201 COMMERCIAL AVE STE B",
"city": "ANACORTES",
"state": "WA",
"postal_code": "982212761",
"telephone_number": "360-873-5318",
"fax_number": "360-371-6243"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1213 24TH ST",
"address_2": "#100",
"city": "ANACORTES",
"state": "WA",
"postal_code": "98221",
"telephone_number": "360-293-3101",
"fax_number": "360-588-1041"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROEDER",
"first_name": "CAROLINE",
"middle_name": "JOY",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-09-19",
"last_updated": "2024-09-24",
"certification_date": "2024-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WA",
"license": "OP60573566",
"primary": true
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WA",
"license": "OL60386634",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2000086",
"state": "WA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "CAROLINE",
"last_name": "WEINHEIMER",
"middle_name": "JOY",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Anacortes, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2024; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.