Individual provider Active NPI

Elizabeth J Carpenter, MD

  • Critical Care Medicine (Internal Medicine) Physician
  • Brandon, FL
National Provider Identifier
1013141514
Registry record updated Jul 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
ME119352 Issued in FL
Practice address
311 Noland Dr
Brandon, FL 33511-5719
Phone
(813) 333-1601
NPI assigned
May 12, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 29, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X ME119352 FL
Critical Care Medicine (Internal Medicine) Physician 207RC0200X ME119352 FL Primary

Addresses

Primary practice location

311 Noland Dr
Brandon, FL 33511-5719

Mailing address

4620 N Habana Ave Ste 101
Tampa, FL 33614-7107
Phone (813) 875-9362

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20150611000311 FL Practitioner - Critical Care (Intensivists)Practitioner - Internal MedicinePractitioner - Pulmonary Disease 2365763760 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeland Regional Health Systems, Inc. Pulmonary Disease CurrentSince Jun 16, 2016 Accepting new patients

Locations

3525 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 603-6565

1324 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 687-1132

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GJBIBA/Endpoint/GJBIBA

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": "1242086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564358400000",
    "number": "1013141514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4620 N HABANA AVE STE 101",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336147107",
            "telephone_number": "813-875-9362",
            "fax_number": "813-876-7055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 NOLAND DR",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115719",
            "telephone_number": "813-333-1601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARPENTER",
        "first_name": "ELIZABETH",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-05-12",
        "last_updated": "2019-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "FL",
            "license": "ME119352",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "FL",
            "license": "ME119352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, FL

Sources for this page

Verify at the official NPI Registry.