NPIMap

Individual provider Active NPI

Richard Lee Carpenter Jr., MD

  • Family Medicine Physician
  • Elloree, SC
National Provider Identifier
1376600486
Registry record updated Jul 9, 2007
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Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
13542 Issued in SC
Practice address
2734 Cleveland Street
Elloree, SC 29047
Phone
(803) 897-2128
NPI assigned
Jan 2, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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 13542 SC Primary

Addresses

Primary practice location

2734 Cleveland Street
Elloree, SC 29047

Mailing address

PO Box 500
Elloree, SC 29047-0500
Phone (803) 897-2128

Other identifiers 4

IdentifierTypeStateIssuer
135428MedicaidSC
GP1311OtherSCMEDICAID GROUP #
570889745OtherSCCHAMPUS #
570889745OtherSCBCBS PROVIDER #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20071219000234 SC Practitioner - Family Practice 5698753846 Practice locations: Elloree, SC

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of South Carolina School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2734 Cleveland St
Elloree, SC 29047-9538
Phone (803) 897-2128

PO Box
Suite 500
Elloree, SC 29047-0500

Hospital & facility affiliations

  • Amedisys Home Health of Lexington Home health agency, Lexington, SC, CCN 427039
  • Grove Park Pharmacy Home Care, LLC Home health agency, Orangeburg, SC, CCN 427861
  • Centerwell Home Health Home health agency, Columbia, SC, CCN 427061
  • Grove Park Pharmacy Hospice Hospice, Orangeburg, SC, CCN 421601
  • Edisto Home Care & Hospice Hospice, Orangeburg, SC, CCN 421634
  • Gentiva Hospice, Aiken, SC, CCN 421552
  • Musc Medical Center Hospital, Charleston, SC, CCN 420004
  • Trident Medical Center Hospital, Charleston, SC, CCN 420079
  • Lexington Medical Center Hospital, West Columbia, SC, CCN 420073
  • McLeod Health Clarendon Hospital, Manning, SC, CCN 420109
  • Prisma Health Baptist Hospital, Columbia, SC, CCN 420086

Merit-based Incentive Payment System (MIPS)

Final score
84.81 of 100Reported as individual
Quality
69.61
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
13542SCMDFamily Medicine Physician

Interoperability endpoints

  • Direct secure messaging: richardcarpenter@elloreefamilypractice.ssdirect.aprima.com

Hospital & facility affiliations 17

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1376600486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 500",
            "city": "ELLOREE",
            "state": "SC",
            "postal_code": "290470500",
            "telephone_number": "803-897-2128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2734 CLEVELAND STREET",
            "city": "ELLOREE",
            "state": "SC",
            "postal_code": "29047",
            "telephone_number": "803-897-2128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARPENTER",
        "first_name": "RICHARD",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-02",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "13542",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "135428",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID GROUP #",
            "identifier": "GP1311",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS #",
            "identifier": "570889745",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER #",
            "identifier": "570889745",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elloree, SC

Sources for this page

Verify at the official NPI Registry.