Individual provider Active NPI

Ronisha Carpenter, PA-C

  • Physician Assistant
  • Savannah, GA
National Provider Identifier
1346663010
Registry record updated Mar 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
11185 Issued in GA
Practice address
1121 Cornell Ave
Savannah, GA 31406-2701
Phone
(912) 785-2100
Fax
(912) 368-3868
NPI assigned
Jan 30, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 11185 GA Primary

Addresses

Primary practice location

1121 Cornell Ave
Savannah, GA 31406-2701

Mailing address

1121 Cornell Ave
Savannah, GA 31406-2701
Phone (912) 785-2100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, OK, GA, NJ4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20140319001725 IL Practitioner - Physician Assistant 0446481238 Reassigns benefits to 3 organizations
I20140827000280 OK Practitioner - Physician Assistant 0446481238 Reassigns benefits to 1 organization
I20230607003000 GA Practitioner - Physician Assistant 0446481238 Reassigns benefits to 2 organizations
I20230821001224 NJ Practitioner - Physician Assistant 0446481238 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Clarity Clinic Arlington Heights LLCGroup PAC ID 0840558094, 29 clinicians

Practice addresses (Care Compare)

2101 S Arlington Heights Rd
Suite 116
Arlington Heights, IL 60005-4142
Phone (847) 666-5339

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11185GAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ou Health Partners, Inc CurrentSince May 13, 2024 Accepting new patients
Bespoke Psychiatry CurrentSince Sep 1, 2021 Accepting new patients
Privia Medical Group of Georgia LLC CurrentSince Mar 25, 2025 Accepting new patients

Locations

3715 Northside Pkwy NW
Bldg 100
Atlanta, GA 30327
Phone (404) 262-7414

101 Yorktown Dr
Ste 100
Fayetteville, GA 30214
Phone (770) 460-4285

1121 Cornell Ave
Savannah, GA 31406
Phone (912) 355-4987

1203 W Augusta Blvd
Ste 1
Chicago, IL 60642
Phone (773) 248-2255

1200 Childrens Ave
Ste 10A
Oklahoma City, OK 73104
Phone (405) 271-4412

900 NE 10th St
Oklahoma City, OK 73104
Phone (405) 271-2230

Interoperability endpoints

  • Direct secure messaging: thrivinglanellc.ronishacarpenter@149897.advancedmd-direct.com

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1391040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742342400000",
    "number": "1346663010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1121 CORNELL AVE",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314062701",
            "telephone_number": "912-785-2100",
            "fax_number": "912-368-3868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1121 CORNELL AVE",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314062701",
            "telephone_number": "912-785-2100",
            "fax_number": "912-368-3868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARPENTER",
        "first_name": "RONISHA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-30",
        "last_updated": "2025-03-19",
        "certification_date": "2025-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "11185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

Verify at the official NPI Registry.