DR. NICOLE POYTHRESS WATERS DO, PHD
NPI 1407416308
Family Medicine in Carrier Mills, IL

Q: What is Nicole Waters's NPI number?

The NPI number for Nicole Waters is 1407416308. It was assigned to this individual provider in the NPPES registry on June 13, 2019.

Q: What is Nicole Waters's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Nicole Waters was last updated on February 6, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since June 13, 2019PECOS EnrolledAccepts Medicare Assignment

7211 US 45 S, CARRIER MILLS, IL 62917(618) 294-8247(618) 294-8247 Get Directions Write a Review

NPPES record last updated: February 6, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Feb 6, 2026, Aug 22, 2023, Jul 6, 2022 and 1 more (4 updates tracked since 2019).

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About Dr. Nicole Poythress Waters Do, Phd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. NICOLE POYTHRESS WATERS DO, PHD (NPI 1407416308) is an individual family medicine provider in Carrier Mills, Illinois, licensed in Illinois (036157809) and active in the NPI registry since June 2019. She is enrolled in Medicare PECOS, is affiliated with Herrin Hospital, and is a graduate of Other (2019).

NPPES Registry Identity

NPI1407416308

Entity TypeIndividualFemale

Primary Taxonomy207Q00000X

Provider Legal NameDR. NICOLE POYTHRESS WATERSCredential: DO, PHD

Location Address7211 US 45 SCarrier Mills, IL 62917-1305

Mailing AddressPo Box 155Christopher, IL 62822-0155 · (618) 724-2401

Phone(618) 294-8247

Fax(618) 294-8247

Sole ProprietorNo

Medical School CMSOtherGraduated 2019

Enumeration DateJune 13, 2019

Last NPPES UpdateFebruary 6, 20264 updates tracked since enumeration

NPPES CertifiedFebruary 6, 2026

✔ NPI 1407416308 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in IL · 036157809

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

7211 US 45 S, Carrier Mills, IL 62917

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Nicole Poythress Waters Do, Phd is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2769717040

PECOS Enrollment IDI20220510001024

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 6

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Emergency department visit with high level of medical decision making 99285

An emergency department visit for severe conditions is when you urgently seek medical help due to serious health issues. These could be severe injuries, breathing problems, unbearable pain, or sudden severe illness. Doctors and nurses will provide immediate care to stabilize your condition.

73 services73 patients

Emergency department visit with moderate level of medical decision making 99284

An emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.

52 services52 patients

Automated urinalysis test 81003

An automated urinalysis test is a routine examination that checks your urine for various substances. It can help identify potential health issues such as kidney problems or diabetes. The test uses a machine to analyze a small urine sample, providing quick and accurate results.

39 services26 patients

Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus and influenza 87428

This test uses a method called immunoassay to identify severe acute respiratory syndrome coronavirus and influenza. It works by detecting specific proteins (antigens) in a sample, like a nasal swab. It's a powerful tool in diagnosing these viral infections.

27 services25 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only 93010

A routine electrocardiogram (ECG) with 12 leads is a simple, non-invasive test that records the electrical activity of your heart. It helps in identifying heart conditions by detecting irregularities in your heart rhythms. The results are interpreted and a report is provided.

27 services23 patients

Critical care, first 30-74 minutes 99291

Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.

15 services15 patients

Hospital Affiliations CMS Care Compare 5

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Herrin Hospital

Acute Care Hospitals · Herrin, IL

1/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140011

Location201 S 14th StHerrin, IL 62948 · Williamson County

Emergency services

Heartland Regional Medical Center

Acute Care Hospitals · Marion, IL

2/5 CMS rating

OwnershipProprietary

CMS Certification Number140184

Location3333 W DeyoungMarion, IL 62959 · Williamson County

Emergency services

Harrisburg Medical Center

Acute Care Hospitals · Harrisburg, IL

3/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number140210

Location100 Doctor Warren Tuttle DrHarrisburg, IL 62946 · Saline County

Emergency services

Massac Memorial Hospital

Critical Access Hospitals · Metropolis, IL

OwnershipProprietary

CMS Certification Number141323

Location28 Chick Street, PO Box 850Metropolis, IL 62960 · Massac County

Emergency services

Marshall Browning Hospital

Critical Access Hospitals · Du Quoin, IL

OwnershipVoluntary non-profit - Private

CMS Certification Number141331

Location900 North Washington StreetDu Quoin, IL 62832 · Perry County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62917 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$85.71 typical visit price

range $54.80 – $168.44

Typical copayment $21.42 (range $13.70 – $42.11)

Most-billed visit code 99203

Established Patient

$97.25 typical visit price

range $17.16 – $136.56

Typical copayment $24.31 (range $4.29 – $34.14)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JENNIFER ELAINE PRICE PA-C

Physician Assistant

7211 US 45 S
CARRIER MILLS, IL 62917

Saline County (618) 294-8246

CHRISTOPHER GREATER AREA RURAL HEALTH PLANNING CORPORATION

Clinic/Center (Federally Qualified Health Center (FQHC))

7211 US 45 S
CARRIER MILLS, IL 62917

Saline County (618) 294-8246

KATRINA L TRIPP PAC

Physician Assistant

7211 US 45 S
CARRIER MILLS, IL 62917

Saline County (618) 209-0498

NATHAN KYLE HEADY PA-C

Physician Assistant

7211 US 45 S
CARRIER MILLS, IL 62917

Saline County (833) 209-0498

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Nicole Waters's NPI number?

The NPI number for Nicole Waters is 1407416308. It was assigned to this individual provider in the NPPES registry on June 13, 2019.

Where is Nicole Waters located?

Nicole Waters practices at 7211 Us 45 S, Carrier Mills, IL 62917. The listed phone number is (618) 294-8247.

What is Nicole Waters's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Nicole Waters enrolled in Medicare?

Yes. Nicole Waters is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Is Nicole Waters affiliated with any hospitals?

According to CMS data, Nicole Waters is affiliated with Herrin Hospital, Heartland Regional Medical Center, Harrisburg Medical Center, Massac Memorial Hospital and Marshall Browning Hospital.

When was this NPI record last updated?

The NPPES record for Nicole Waters was last updated on February 6, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.