Individual provider Active NPI

Robert G Carpenter, M.D.

  • Internal Medicine Physician
  • Roanoke, VA
National Provider Identifier
1225010184
Registry record updated Apr 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0101277892 Issued in VA
Practice address
3 Riverside Cir Ste 1006
Roanoke, VA 24016-4955
Phone
(540) 224-5352
NPI assigned
Nov 16, 2005
Last updated
Apr 20, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD19517 ME
Internal Medicine Physician 207R00000X MD19517 ME
Internal Medicine Physician 207R00000X 0101277892 VA Primary
Rheumatology Physician 207RR0500X MD19517 ME

Addresses

Primary practice location

3 Riverside Cir Ste 1006
Roanoke, VA 24016-4955

Mailing address

1 Medical Center Dr
Biddeford, ME 04005-9422
Phone (207) 282-9080

Other practice location 1

2 Livewell Dr
Kennebunk, ME 04043-6762
Phone (207) 467-6972

Other practice location 2

72 Main St
Kennebunk, ME 04043-7021
Phone (207) 467-8909

Other identifiers 3

IdentifierTypeStateIssuer
1225010184MedicaidME
845433OtherMEAETNA
1225010184OtherMEANTHEM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME, VA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20130201000009 ME Practitioner - Internal Medicine 0648166322 Reassigns benefits to 1 organization
I20230510001383 VA Practitioner - Internal Medicine 0648166322 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carilion Medical CenterGroup PAC ID 9830096585, 956 clinicians

Practice addresses (Care Compare)

2017 Jefferson St SW
Roanoke, VA 24014-2419
Phone (540) 981-7925

2017 S Jefferson St
Roanoke, VA 24014-2419
Phone (540) 981-7128

3 Riverside Cir
Roanoke, VA 24016-4955
Phone (540) 224-5170

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD19517MEMDRheumatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carilion Medical Center CurrentSince Jun 19, 2023 Accepting new patients
Mainehealth CurrentSince Dec 17, 2012 Accepting new patients
Mainehealth CurrentSince Dec 17, 2012 Accepting new patients
Carilion Medical Center CurrentSince Jun 19, 2023 Accepting new patients
Carilion Medical Center Past Accepting new patients

Locations

1 Medical Dr
Biddeford, ME 04005
Phone (207) 283-7000

2 Livewell Dr
Kennebunk, ME 04043
Phone (207) 467-6900

72 Main St
Kennebunk, ME 04043
Phone (207) 467-8810

2017 Jefferson St SW
Roanoke, VA 24014
Phone (540) 981-7128

213 S Jefferson St
Ste 1006
Roanoke, VA 24011
Phone (540) 224-5353

3 Riverside Cir
Roanoke, VA 24016

3 Riverside Cir
Ste 1006
Roanoke, VA 24016

Interoperability endpoints

  • Direct secure messaging: rcarpenter167253@direct.carilionclinic.org
  • Direct secure messaging: robert.carpenter.1@18289.direct.athenahealth.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1132099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681948800000",
    "number": "1225010184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "city": "BIDDEFORD",
            "state": "ME",
            "postal_code": "040059422",
            "telephone_number": "207-282-9080",
            "fax_number": "207-467-8910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 RIVERSIDE CIR STE 1006",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240164955",
            "telephone_number": "540-224-5352"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2 Livewell Dr",
            "address_purpose": "LOCATION",
            "city": "Kennebunk",
            "state": "ME",
            "postal_code": "040436762",
            "country_code": "US",
            "telephone_number": "207-467-6972",
            "fax_number": "207-467-6972",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "72 Main St",
            "address_purpose": "LOCATION",
            "city": "Kennebunk",
            "state": "ME",
            "postal_code": "040437021",
            "country_code": "US",
            "telephone_number": "207-467-8909",
            "fax_number": "207-467-8910",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARPENTER",
        "first_name": "ROBERT",
        "middle_name": "G",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-16",
        "last_updated": "2023-04-20",
        "certification_date": "2023-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ME",
            "license": "MD19517",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "ME",
            "license": "MD19517",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101277892",
            "primary": true
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "ME",
            "license": "MD19517",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1225010184",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "845433",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "1225010184",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

Verify at the official NPI Registry.