Individual provider Active NPI

Nicole Sechrist Carney, DPM

  • Podiatrist
  • Olympia, WA
National Provider Identifier
1871678748
Registry record updated Jul 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
PO6YO Issued in WA
Practice address
520 Lilly Rd NE
BLDG 1
Olympia, WA 98506-5255
Phone
(360) 438-9092
Fax
(360) 438-3906
NPI assigned
Oct 26, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 5, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X PO6YO WA Primary

Addresses

Primary practice location

520 Lilly Rd NE
BLDG 1
Olympia, WA 98506-5255

Mailing address

520 Lilly Rd NE
BLDG 1
Olympia, WA 98506-5255
Phone (360) 438-9092

Other identifiers 2

IdentifierTypeStateIssuer
CA2730OtherWAREGENCE RIDER
1109560MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20081003000394 WA Practitioner - Podiatry 3375611585 Practice locations: Olympia, WA
O20100930019058 WA DME Supplier - Physician - Podiatry 6002937877 Practice locations: Olympia, WA

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
California School of Podiatric Medicine, 1995
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

520 Lilly Rd NE
BLDG 1
Olympia, WA 98506-5255
Phone (360) 701-0430

Hospital & facility affiliations

  • Providence St Peter Hospital Hospital, Olympia, WA, CCN 500024

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of nail tissue324
Removal or shaving of skin growth152

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PO6YOWAMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Neuromuscular Associates PC Past Accepting new patients
Kelley a. Gillroy-Gill Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: ncarney@1272.securemail.prognocis.com

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530748800000",
    "number": "1871678748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 LILLY RD NE",
            "address_2": "BLDG 1",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065255",
            "telephone_number": "360-438-9092",
            "fax_number": "360-438-3906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 LILLY RD NE",
            "address_2": "BLDG 1",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065255",
            "telephone_number": "360-438-9092",
            "fax_number": "360-438-3906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARNEY",
        "first_name": "NICOLE",
        "middle_name": "SECHRIST",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-26",
        "last_updated": "2018-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "WA",
            "license": "PO6YO",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE RIDER",
            "identifier": "CA2730",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1109560",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Olympia, WA

Sources for this page

Verify at the official NPI Registry.