Carrie Ann Matyac, ARNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

AP30006999 Issued in WA

Practice address

2555 Marvin Rd NE
PMG SW Wa Hawks Prairie Im
Lacey, WA 98516-3138

Phone

(360) 923-4600

Fax

(360) 412-2256

NPI assigned

Apr 27, 2006

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cmatyac545532@wm.providencedirect.org

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.

• Jamestown S'Klallam Tribe

  • Federally Qualified Health Center (FQHC)
  • Sequim, WA
  • NPI 1134181555
  Medicare reassignment NPD
• Providence Health & Services Washington

  • Family Medicine Physician
  • Olympia, WA
  • NPI 1174744304
  Medicare reassignment
• Jamestown S'Klallam Tribe

  • Family Medicine Physician
  • Sequim, WA
  • NPI 1528809761
  NPD
• Capital Clubhouse

  • Community/Behavioral Health Agency
  • Olympia, WA
  • NPI 1255571063
  NPD (past)
• Leyton Endicott Jump

  • Family Medicine Physician
  • Tenino, WA
  • NPI 1851357008
  NPD (past)
• Tenino Family Practice PLLC

  • Adolescent Medicine (Family Medicine) Physician
  • Tenino, WA
  • NPI 1487056511
  NPD (past)

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

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623888000000",
    "number": "1669439451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3360",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2555 MARVIN RD NE",
            "address_2": "PMG SW WA HAWKS PRAIRIE IM",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985163138",
            "telephone_number": "360-923-4600",
            "fax_number": "360-412-2256"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1620 Cooper Point Rd SW",
            "address_purpose": "LOCATION",
            "city": "Olympia",
            "state": "WA",
            "postal_code": "985025736",
            "country_code": "US",
            "telephone_number": "360-486-6710",
            "fax_number": "360-705-0269",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATYAC",
        "first_name": "CARRIE",
        "middle_name": "ANN",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-27",
        "last_updated": "2021-06-17",
        "certification_date": "2021-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP30006999",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cmatyac545532@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1620 Cooper Point Rd SW",
            "city": "Olympia",
            "state": "WA",
            "country_code": "US",
            "postal_code": "985025736",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Mark S Mathews, P.A.
• Alaysha Nichole Matronia, OTD, OTR/L
• Rebekah Mattes, ATC, LAT
• Matthew D Wall DDS MSD PLLC
• Gary Buhrmester Mattix, LDO
• Hugh Mau, RPH
• Matthew Cecil Maxfield, ARNP, PMHNP-BC
• Maxim Healthcare Services, Inc.
• Samantha May
• Maz Adult Family Home LLC

• Nurse Practitioner in Lacey, WA
• Providers in Lacey, WA by specialty
• Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.