Jacob Carpenter, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95004394 Issued in CA

Practice address

45104 10TH St W
Lancaster, CA 93534-2310

Phone

(661) 942-2391

NPI assigned

Apr 6, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

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

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jacob.carpenter.p11@direct.kmsm.nextgenshare.com
• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Mathias Primary Care Associates, Inc

  • Internal Medicine Physician
  • Hemet, CA
  • NPI 1508524083
  Medicare reassignment NPD

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

{
    "created_epoch": "1459900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467504000000",
    "number": "1295199263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45104 10TH ST W",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935342310",
            "telephone_number": "661-942-2391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45104 10TH ST W",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935342310",
            "telephone_number": "661-942-2391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARPENTER",
        "first_name": "JACOB",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-04-06",
        "last_updated": "2016-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95004394",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "95004394",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Susan Rene Carlton
• Thomas Grant Carlton, M.D.
• Carmel I. Ernest, M.D., Inc.
• Monica Carmona
• Henry Jay Carpenter, DPO
• Amber Marie Carra, LMFT117061
• Cindy Carrasco
• Oscar Alberto Carrasco
• Isela Carreno
• Jose Jr Carreon-Bennett

• Family Nurse Practitioner in Lancaster, CA
• Providers in Lancaster, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2016; 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.