Individual provider Active NPI

Ryan Carpenter

  • Adult Health Clinical Nurse Specialist
  • Austin, TX
National Provider Identifier
1255740098
Registry record updated Dec 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Clinical Nurse SpecialistTaxonomy code 364SA2200X
License
AP125878 Issued in TX
Practice address
1108 Lavaca St Ste 110-320
Austin, TX 78701-2172
Phone
(512) 477-4088
Fax
(512) 482-0390
NPI assigned
Aug 6, 2014
Last updated
Dec 23, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Clinical Nurse Specialist 364SA2200X AP125878 TX Primary

Addresses

Primary practice location

1108 Lavaca St Ste 110-320
Austin, TX 78701-2172

Mailing address

7620 Deer Run
Volente, TX 78641-6108
Phone (512) 351-1035

Other identifiers 1

IdentifierTypeStateIssuer
343379602MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20141124000588 TX Practitioner - Nurse Practitioner 5991027237 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Austin Geriatric Specialists PLLCGroup PAC ID 5092770511, 59 clinicians

Practice addresses (Care Compare)

11406 Rustic Rock Dr
Austin, TX 78750-3505
Phone (512) 477-4088

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP125878TXMDAdult Health Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Austin Geriatric Specialists, PLLC CurrentSince Jun 1, 2016 Accepting new patients
Hni Medical Services Past Accepting new patients

Locations

1108 Lavaca St
Ste 110320
Austin, TX 78701
Phone (512) 482-0390

11406 Rustic Rock Dr
Austin, TX 78750
Phone (512) 251-3915

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/18292/brand/1/csg/1/fhir/r4
  • FHIR API: https://api.platform.athenahealth.com/25850/brand/1/csg/1/fhir/r4
  • Direct secure messaging: ryan.carpenter.1@25850.direct.athenahealth.com

Organizations & group practices 2

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 1

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": "1407283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482451200000",
    "number": "1255740098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7620 DEER RUN",
            "city": "VOLENTE",
            "state": "TX",
            "postal_code": "786416108",
            "telephone_number": "512-351-1035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1108 LAVACA ST STE 110-320",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787012172",
            "telephone_number": "512-477-4088",
            "fax_number": "512-482-0390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARPENTER",
        "first_name": "RYAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-08-06",
        "last_updated": "2016-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SA2200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Adult Health",
            "state": "TX",
            "license": "AP125878",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "343379602",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.