Olly C Duckett, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

200000778 Issued in NC

Practice address

3000 New Bern Ave
Raleigh, NC 27610-1231

Phone

(843) 237-3378

Fax

(843) 237-5073

NPI assigned

Apr 12, 2006

Sex

Male

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 4

Medicare fee-for-service enrollment

Enrolled in NC, VA2 enrollments

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 2

Specialty

Emergency Medicine

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wake Emergency Physicians PAGroup PAC ID 9931002078, 269 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wakemed, Raleigh Campus Hospital, Raleigh, NC, CCN 340069

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: oduckett39610@directhisp.wakemed.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.

• Wake Emergency Physicians PA

  • Emergency Medicine Physician
  • Raleigh, NC
  • NPI 1922063387
  Medicare reassignment Care Compare group NPD
• Privia Medical Group, LLC

  • Internal Medicine Physician
  • Arlington, VA
  • NPI 1013042480
  Medicare reassignment
• Wake Emergency Physicians PA

  • Emergency Medicine Physician
  • Goldsboro, NC
  • NPI 1619758018
  NPD
• Wake Emergency Physicians PA

  • Emergency Medicine Physician
  • Oxford, NC
  • NPI 1972842839
  NPD

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

• Wakemed

  • Psychiatric Hospital Unit
  • Raleigh, NC
  • NPI 1780446302
  Care Compare affiliation
• Wakemed

  • General Acute Care Hospital
  • Raleigh, NC
  • NPI 1972579837
  Care Compare affiliation

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

{
    "created_epoch": "1144800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1237248000000",
    "number": "1922061654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60968",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600968",
            "telephone_number": "843-237-3378",
            "fax_number": "843-237-5073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 NEW BERN AVE",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276101231",
            "telephone_number": "843-237-3378",
            "fax_number": "843-237-5073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUCKETT",
        "first_name": "OLLY",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-12",
        "last_updated": "2009-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "200000778",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "050076113",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q0077E",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89127HX",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "127HX",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dublin Home Care, LLC
• Sirraiyiah Dublin
• David A Dubow, MD
• Katherine Ducharme, MA
• Carlos A. Duchesne, M.D.
• Tiffany Young Duckett, NP
• Jesse Severino Dudas
• Jency Jenee' Dueitt, LCSW
• Nathan Gregory Duell
• Kelly Duewer, PA

• Emergency Medicine Physician in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Emergency Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2009; 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.
• 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.