Melissa L Carpenter

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

CB.61383194 Issued in WA

Practice address

1605 Woodridge Dr SE
Port Orchard, WA 98366-3818

Phone

(360) 443-2399

Fax

(360) 443-6121

NPI assigned

Dec 9, 2022

Last updated

Dec 9, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Melissa Wagner Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Tiny Notes Music and Movement LLC

  dba Tiny Notes Enrichment Center

  • Early Intervention Provider Agency
  • Port Orchard, WA
  • NPI 1124793518
  NPD

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

{
    "created_epoch": "1670544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670544000000",
    "number": "1306557475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1605 WOODRIDGE DR SE",
            "city": "PORT ORCHARD",
            "state": "WA",
            "postal_code": "983663818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1605 WOODRIDGE DR SE",
            "city": "PORT ORCHARD",
            "state": "WA",
            "postal_code": "983663818",
            "telephone_number": "360-443-2399",
            "fax_number": "360-443-6121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARPENTER",
        "first_name": "MELISSA",
        "middle_name": "L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-12-09",
        "last_updated": "2022-12-09",
        "certification_date": "2022-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Technician",
            "state": "WA",
            "license": "CB.61383194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "WAGNER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jerline R Carey, PT
• Rachelle Marie Avecilla Carino
• Carlos Caballero DDS,Ms, PS (Master Orthodontics)
• John Robert Carlson, PT
• Andre B Caron, PT
• Leah Grace Carroll, MS, CCC-SLP
• Andrew David Carter, M.A.
• Destiny Brooke Carter
• Marieta Sharon Cartwright, LMP
• Cascade Medical Investors Limited Partnership (Life Care Center of Port Orchard)

• Behavior Technician in Port Orchard, WA
• Providers in Port Orchard, WA by specialty
• Behavior Technician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2022; 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.