Taniya Carpenter, R.N.

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

130959 Issued in MO

Practice address

402 Recovery Rd
Kennett, MO 63857-3235

Phone

(573) 888-2831

Fax

(573) 888-5408

NPI assigned

Mar 27, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MO

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Registered Nurse

State licenses

Practice roles

Locations

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.

• Rural Health Pain Management LLC

  • Pain Medicine (Anesthesiology) Physician
  • Forrest City, AR
  • NPI 1265039556

  MO

  Medicare reassignment NPD

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299456000000",
    "number": "1235257304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 RECOVERY RD",
            "city": "KENNETT",
            "state": "MO",
            "postal_code": "638573235",
            "telephone_number": "573-888-2831",
            "fax_number": "573-888-5408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 RECOVERY RD",
            "city": "KENNETT",
            "state": "MO",
            "postal_code": "638573235",
            "telephone_number": "573-888-2831",
            "fax_number": "573-888-5408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARPENTER",
        "first_name": "TANIYA",
        "name_prefix": "Mrs.",
        "credential": "R.N.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-27",
        "last_updated": "2011-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MO",
            "license": "130959",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "130959",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "130959",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Myra Callahan
• Robin Callahan
• Jamie Callis
• Adrienne Elois Calvert, LPC
• Andrea Campbell
• Krystal Carr
• Jessica Carter
• Tina L Carter, LCSW
• Gabrielle Sheyanne Carver
• April Danelle Cates

• Family Nurse Practitioner in Kennett, MO
• Providers in Kennett, MO by specialty
• Family Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2011; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.