Grace Lauren Carpenter

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

45021866A Issued in IN

Practice address

5215 Holy Cross Pkwy
Mishawaka, IN 46545-1469

Phone

(574) 850-6441

NPI assigned

Mar 15, 2023

Last updated

Mar 15, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Saint Joseph Regional Medical Center-South Bend Campus, Inc.

  dba Family Medicine Center of SJRMC

  • Family Medicine Physician
  • Mishawaka, IN
  • NPI 1780766261
  NPD (past)

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

{
    "created_epoch": "1678838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678838400000",
    "number": "1326749391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4028 HARRISON CREEK CT",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465449159",
            "telephone_number": "574-850-6441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5215 HOLY CROSS PKWY",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465451469",
            "telephone_number": "574-850-6441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARPENTER",
        "first_name": "GRACE",
        "middle_name": "LAUREN",
        "name_prefix": "Miss",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-15",
        "last_updated": "2023-03-15",
        "certification_date": "2023-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IN",
            "license": "45021866A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carrie Michele Cardwell
• Care First Services LLC
• Care First Services LLC (iMax Technologies)
• Caring Cove Hospice LLC
• Elizabeth A. Carpenter, PTA
• Tiana Carr
• Barbara A Carrasco, LCSW
• Tina Louise Carrera-Segundo, LPN
• Bryan Erhard Carson
• Joelle Marie Carson

• Student in an Organized Health Care Education/Training Program in Mishawaka, IN
• Providers in Mishawaka, IN by specialty
• Student in an Organized Health Care Education/Training Program in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2023; 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.