Mason Konnor Carpenter, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA4875 Issued in AR

Practice address

2100 W Main St
Russellville, AR 72801-2758

Phone

(479) 968-2525

NPI assigned

Jun 9, 2026

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• River Valley Therapy & Sports Medicine Inc

  • Physical Therapist
  • Russellville, AR
  • NPI 1619925732
  NPD (past)

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

{
    "created_epoch": "1780963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780963200000",
    "number": "1336073071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 PHILLIPS RD",
            "city": "POTTSVILLE",
            "state": "AR",
            "postal_code": "728588838",
            "telephone_number": "479-968-2525",
            "fax_number": "479-968-2539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 W MAIN ST",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728012758",
            "telephone_number": "479-968-2525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARPENTER",
        "first_name": "MASON",
        "middle_name": "KONNOR",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-06-09",
        "last_updated": "2026-06-09",
        "certification_date": "2026-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapy Assistant",
            "state": "AR",
            "license": "PTA4875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maggu Mae Cano
• Hayden Cantrell, LAC
• Care IV, Inc.
• Carmella M. Knoernschild, DDS, PA
• Leticia Rebecca Caro
• Shaley Christine Carpenter
• Cheyenne Carr
• Alicia Cristina Carro Jimenez
• Phylana K Carruth, RN
• Camryn Jade Carter, COTA/L

• Physical Therapy Assistant in Russellville, AR
• Providers in Russellville, AR by specialty
• Physical Therapy Assistant in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2026; 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.