Dr Nicole Poythress Waters, DO, PHD - Medicare Family Medicine in Carrier Mills, IL

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Dr Nicole Poythress Waters, DO, PHD is a medicare enrolled "Family Medicine" physician in Carrier Mills, Illinois. Her current practice location is 7211 Us 45 S, Carrier Mills, Illinois. You can reach out to her office (for appointments etc.) via phone at (618) 294-8247.

Dr Nicole Poythress Waters is licensed to practice in Illinois (license number 036157809) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1407416308.

Contact Information

Dr Nicole Poythress Waters, DO, PHD
7211 Us 45 S,
Carrier Mills, IL 62917-1305
(618) 294-8247
(618) 294-8247

Map and Direction




Physician's Profile

Full NameDr Nicole Poythress Waters
GenderFemale
SpecialityFamily Medicine
Location7211 Us 45 S, Carrier Mills, Illinois
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1407416308
  • Provider Enumeration Date: 06/13/2019
  • Last Update Date: 08/22/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 2769717040
  • Enrollment ID: I20220510001024

Medical Identifiers

Medical identifiers for Dr Nicole Poythress Waters such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1407416308NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207Q00000XFamily Medicine 036157809 (Illinois)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Nicole Poythress Waters allows following entities to bill medicare on her behalf.
Entity NameShawnee Health Service And Development Corp
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1639295314
PECOS PAC ID: 1658285671
Enrollment ID: O20031120000454
Entity NameChristopher Greater Area Rural Health Planning Corporation
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1073816542
PECOS PAC ID: 8224947387
Enrollment ID: O20040109000561
Entity NameIntegritas Emergency Physician Services Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1790128817
PECOS PAC ID: 7113167446
Enrollment ID: O20130710000760
Entity NameStatera Health Care Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1043874449
PECOS PAC ID: 0244565729
Enrollment ID: O20190708000284

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Nicole Poythress Waters is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Dr Nicole Poythress Waters, DO, PHD
Po Box 155,
Christopher, IL 62822-0155

Ph: (618) 724-2401		Dr Nicole Poythress Waters, DO, PHD
7211 Us 45 S,
Carrier Mills, IL 62917-1305

Ph: (618) 294-8247

Reviews and Comments


Family Medicine Doctors in Carrier Mills, IL


Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.