Active NPI
Justine Carpenter, LMT
- Specialist
- Bend, OR
National Provider Identifier
1093118564
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 20803
- Practice address
- 497 SW Century Dr
Suite 120
Bend, OR 97702-1167 - Phone
- (541) 480-1240
- NPI assigned
- Sep 29, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 20803 | OR | Primary |
Addresses
Primary practice location
497 SW Century Dr
Suite 120
Bend, OR 97702-1167
Mailing address
497 SW Century Dr
Suite 120
Bend, OR 97702-1167
Phone (541) 480-1240
Other names 1
- Justine Larsen
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20803 | OR | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1411948800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1411948800000",
"number": "1093118564",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "497 SW CENTURY DR",
"address_2": "SUITE 120",
"city": "BEND",
"state": "OR",
"postal_code": "977021167",
"telephone_number": "541-480-1240"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "497 SW CENTURY DR",
"address_2": "SUITE 120",
"city": "BEND",
"state": "OR",
"postal_code": "977021167",
"telephone_number": "541-480-1240"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARPENTER",
"first_name": "JUSTINE",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-09-29",
"last_updated": "2014-09-29",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "OR",
"license": "20803",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JUSTINE",
"last_name": "LARSEN",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Bend, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.