Individual provider Active NPI

Carris Bentick Carter

  • Psychiatric/Mental Health Nurse Practitioner
  • Ellenwood, GA
National Provider Identifier
1235075987
Registry record updated Apr 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN322234 Issued in GA
Practice address
4652 River Vista TRL
Ellenwood, GA 30294-6714
Phone
(678) 914-3018
NPI assigned
Apr 27, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RN322234 GA Primary

Addresses

Primary practice location

4652 River Vista TRL
Ellenwood, GA 30294-6714

Mailing address

4652 River Vista TRL
Ellenwood, GA 30294-6714

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

LicenseStateTypeSpecialty
RN322234GAMDPsychiatric/Mental Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1777248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777248000000",
    "number": "1235075987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4652 RIVER VISTA TRL",
            "city": "ELLENWOOD",
            "state": "GA",
            "postal_code": "302946714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4652 RIVER VISTA TRL",
            "city": "ELLENWOOD",
            "state": "GA",
            "postal_code": "302946714",
            "telephone_number": "678-914-3018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENTICK CARTER",
        "first_name": "CARRIS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-04-27",
        "last_updated": "2026-04-27",
        "certification_date": "2026-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "RN322234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellenwood, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.