Individual provider Active NPI

Brian D Carpenter, PH.D.

  • Clinical Psychologist
  • Saint Louis, MO
National Provider Identifier
1023010972
Registry record updated Dec 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
2000166306 Issued in MO
Practice address
7 N Jackson Rd
Psychological Services Center
Saint Louis, MO 63105-2153
Phone
(314) 935-8212
NPI assigned
Aug 11, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 29, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 2000166306 MO Primary

Addresses

Primary practice location

7 N Jackson Rd
Psychological Services Center
Saint Louis, MO 63105-2153

Mailing address

7 N Jackson Rd
Psychological Services Center
Saint Louis, MO 63105-2153
Phone (314) 935-8212

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100802000892 MO Practitioner - Clinical Psychologist 6901939628 Practice locations: Saint Louis, MO

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

7 N Jackson Rd
Saint Louis, MO 63105-2153
Phone (314) 935-8212

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2000166306MOMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Neuropsychology of St. Louis, LLC Past Accepting new patients

Organizations & group practices 1

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": "1123718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419811200000",
    "number": "1023010972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 N JACKSON RD",
            "address_2": "PSYCHOLOGICAL SERVICES CENTER",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631052153",
            "telephone_number": "314-935-8212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 N JACKSON RD",
            "address_2": "PSYCHOLOGICAL SERVICES CENTER",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631052153",
            "telephone_number": "314-935-8212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARPENTER",
        "first_name": "BRIAN",
        "middle_name": "D",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-11",
        "last_updated": "2014-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MO",
            "license": "2000166306",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.