Robert Walter Carpenter, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

9573353-1206 Issued in UT

Practice address

2121 N 1700 W
Layton, UT 84041-8803

Phone

(801) 773-4840

Fax

(801) 525-8151

NPI assigned

Sep 7, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

University of Washington School of Medicine, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Interventional Spine and Pain ManagementGroup PAC ID 6204065162, 13 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: robert.carpenter.p1@direct.tannerclinic.nextgenshare.com

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.

• Interventional Spine & Pain Management

  • Pain Medicine (Anesthesiology) Physician
  • Murray, UT
  • NPI 1609204338
  Medicare reassignment Care Compare group
• Tanner Memorial Clinic

  • Internal Medicine Physician
  • Layton, UT
  • NPI 1447239355
  NPD
• Tanner Memorial Clinic

  • Multi-Specialty Clinic/Center
  • Layton, UT
  • NPI 1538951165
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1536278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773100800000",
    "number": "1174006928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 337",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840410337",
            "telephone_number": "801-773-4840",
            "fax_number": "801-525-8151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 N 1700 W",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840418803",
            "telephone_number": "801-773-4840",
            "fax_number": "801-525-8151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARPENTER",
        "first_name": "ROBERT",
        "middle_name": "WALTER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-07",
        "last_updated": "2026-03-10",
        "certification_date": "2026-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "9573353-1206",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jean Marie Carlson, COTA
• Jayden Carpenter
• Kelsi Carpenter
• McKenna Carpenter, BT
• Rachel Carpenter
• Connie C Carr, COTA/L
• Lydielle Carr
• Michelle Carreno Rojas
• Gisell Carreno, MS
• Brittany Carroll

• Physician Assistant in Layton, UT
• Providers in Layton, UT by specialty
• Physician Assistant in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.