Individual provider Active NPI

Carrie Ann Roller, MD

  • Otolaryngology Physician
  • Spokane, WA
National Provider Identifier
1750486874
Registry record updated Nov 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
MD00048480 Issued in WA
Practice address
217 W Cataldo Ave FL 3
Spokane, WA 99201-2217
Phone
(509) 747-6194
Fax
(509) 838-0824
NPI assigned
Sep 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X A82174 CA
Pediatric Otolaryngology Physician 207YP0228X MD00048480 WA
Otolaryngology Physician 207Y00000X MD00048480 WA Primary

Addresses

Primary practice location

217 W Cataldo Ave FL 3
Spokane, WA 99201-2217

Mailing address

PO Box 421
Liberty Lake, WA 99019-0421
Phone (866) 747-2455

Other identifiers 3

IdentifierTypeStateIssuer
P000464176OtherWARAILROAD MEDICARE
226035OtherWALABOR & INDUSTRIES
1045537MedicaidWA

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070917000617 WA Practitioner - Otolaryngology 7517051873 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A82174CAMDOtolaryngology Physician
MD00048480WAMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Columbia Surgical Specialists, PS CurrentSince Oct 1, 2007 Accepting new patients
Columbia Surgical Specialists, PS Otolaryngology CurrentSince Oct 1, 2007 Accepting new patients

Locations

9922 N Nevada St
Spokane, WA 99218
Phone (509) 624-2326

217 W Cataldo Ave
Spokane, WA 99201
Phone (509) 624-2326

217 W Cataldo Ave
Fl 3
Spokane, WA 99201
Phone (509) 624-2326

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669680000000",
    "number": "1750486874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 421",
            "city": "LIBERTY LAKE",
            "state": "WA",
            "postal_code": "990190421",
            "telephone_number": "866-747-2455",
            "fax_number": "509-227-7070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 W CATALDO AVE FL 3",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992012217",
            "telephone_number": "509-747-6194",
            "fax_number": "509-838-0824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROLLER",
        "first_name": "CARRIE",
        "middle_name": "ANN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-13",
        "last_updated": "2022-11-29",
        "certification_date": "2022-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "A82174",
            "primary": false
        },
        {
            "code": "207YP0228X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Pediatric Otolaryngology",
            "state": "WA",
            "license": "MD00048480",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "WA",
            "license": "MD00048480",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P000464176",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRIES",
            "identifier": "226035",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1045537",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.