NPIMap

Individual provider Active NPI

Bruce D Carpenter, M.D.

  • Family Medicine Physician
  • Granbury, TX
National Provider Identifier
1346298031
Registry record updated Jan 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
F6508 Issued in TX
Practice address
2800 Village Rd
108
Granbury, TX 76049-4193
Phone
(817) 573-0444
Fax
(817) 573-2733
NPI assigned
May 4, 2006
Last updated
Jan 12, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 12, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X F6508 TX Primary

Addresses

Primary practice location

2800 Village Rd
108
Granbury, TX 76049-4193

Mailing address

409 Glenwood St
500
Glen Rose, TX 76043-4933
Phone (254) 897-2202

Other identifiers 2

IdentifierTypeStateIssuer
130769611MedicaidTX
191011901MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040130000040 TX Practitioner - Family PracticePractitioner - Internal MedicinePractitioner - Emergency Medicine 7911800644 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Emergency Medicine
Education
University of Texas Medical Branch at Galveston, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Concord Medical Group of Texas PLLCGroup PAC ID 7810117223, 319 clinicians
Glen Rose Healthcare, IncGroup PAC ID 6709986656, 12 clinicians

Practice addresses (Care Compare)

1021 Holden St
Glen Rose, TX 76043-4937
Phone (254) 897-2215

2800 Village Rd
Suite 108
Granbury, TX 76049-4194
Phone (817) 573-0444

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.65 of 100Reported as individual
Quality
100
Promoting interoperability
100
Improvement activities
40
Cost
58.85

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Removal of skin lesions65
Removal of nail tissue1-10
Removal or shaving of skin growth41
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Glen Rose Healthcare, Inc Family Medicine CurrentSince Jun 1, 2010 Accepting new patients
Concord Medical Group of Texas PLLC CurrentSince Nov 12, 2021 Accepting new patients
Glen Rose Medical Foundation Past Accepting new patients

Locations

200 S Geneva St
Breckenridge, TX 76424
Phone (254) 559-2241

1021 Holden St
Glen Rose, TX 76043
Phone (254) 897-1425

1021 Holden St
#200
Glen Rose, TX 76043
Phone (254) 897-1645

1021 Holden St
Ste 200
Glen Rose, TX 76043
Phone (254) 897-3310

409 Glenwood St
#500
Glen Rose, TX 76043
Phone (254) 897-1471

2800 Village Rd
Ste 108
Granbury, TX 76049
Phone (817) 573-0444

Interoperability endpoints

  • Direct secure messaging: bruce.carpenter.1@1948.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/1948/brand/1/csg/1/fhir/r4

Organizations & group practices 4

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 7

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": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484179200000",
    "number": "1346298031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 GLENWOOD ST",
            "address_2": "500",
            "city": "GLEN ROSE",
            "state": "TX",
            "postal_code": "760434933",
            "telephone_number": "254-897-2202",
            "fax_number": "254-897-1638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 VILLAGE RD",
            "address_2": "108",
            "city": "GRANBURY",
            "state": "TX",
            "postal_code": "760494193",
            "telephone_number": "817-573-0444",
            "fax_number": "817-573-2733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARPENTER",
        "first_name": "BRUCE",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2017-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "F6508",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "130769611",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "191011901",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Granbury, TX

Sources for this page

Verify at the official NPI Registry.