Individual provider Active NPI

Paul Carpenter, DPT

  • Physical Therapist
  • Little Falls, MN
National Provider Identifier
1386079846
Registry record updated Oct 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
9226 Issued in MN
Practice address
104 2ND St SE
Little Falls, MN 56345
Phone
(320) 414-0404
Fax
(320) 348-1239
NPI assigned
Sep 3, 2013
Last updated
Oct 4, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 9226 MN Primary

Addresses

Primary practice location

104 2ND St SE
Little Falls, MN 56345

Mailing address

104 2ND St SE
Little Falls, MN 56345-3037
Phone (320) 414-0404

Other practice location 1

224 Shorter Ave NW
Rome, GA 30165-4288
Phone (706) 235-2727

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170201000255 MN Practitioner - Physical Therapist in Private Practice 3870729452 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9226MNMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Woodlands Chiropractic PA CurrentSince Dec 10, 2016 Accepting new patients
Interventional Pain & Physical Medicine Clinic Physical Therapist CurrentSince Jul 2, 2021 Accepting new patients
Interventional Pain & Physical Medicine Clinic CurrentSince Jul 2, 2021 Accepting new patients
Advance Rehabilitation and Consulting Physical Therapist Past Accepting new patients

Locations

48 29th Ave N
Saint Cloud, MN 56303
Phone (320) 240-0300

2301 Connecticut Ave S
Sartell, MN 56377
Phone (320) 229-1500

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1378166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570147200000",
    "number": "1386079846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 2ND ST SE",
            "city": "LITTLE FALLS",
            "state": "MN",
            "postal_code": "563453037",
            "telephone_number": "320-414-0404",
            "fax_number": "320-348-1239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 2ND ST SE",
            "city": "LITTLE FALLS",
            "state": "MN",
            "postal_code": "56345",
            "telephone_number": "320-414-0404",
            "fax_number": "320-348-1239"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "224 Shorter Ave NW",
            "address_purpose": "LOCATION",
            "city": "Rome",
            "state": "GA",
            "postal_code": "301654288",
            "country_code": "US",
            "telephone_number": "706-235-2727",
            "fax_number": "706-235-2726",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARPENTER",
        "first_name": "PAUL",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-09-03",
        "last_updated": "2019-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "9226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Falls, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.