Individual provider Active NPI

Christina R. Carpenter, PA-C

  • Physician Assistant
  • Port Matilda, PA
National Provider Identifier
1407044266
Registry record updated Jul 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA053180 Issued in PA
Practice address
132 Abigail LN
Port Matilda, PA 16870-7153
Phone
(814) 272-7100
Fax
(814) 272-6501
NPI assigned
Oct 5, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2020

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 MA053180 PA Primary

Addresses

Primary practice location

132 Abigail LN
Port Matilda, PA 16870-7153

Mailing address

100 N Academy Ave
Danville, PA 17822-4903
Phone (570) 271-6144

Other names 1

  • Christina R. Shawver Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cciambotti84750@direct.geisinger.edu Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
MA053180PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic CurrentSince Nov 1, 2007 Accepting new patients
Geisinger Clinic CurrentSince Nov 1, 2007 Accepting new patients
University Ambulance Service Past Accepting new patients
Windber Hospital, Inc. Past Accepting new patients

Locations

100 N Academy Ave
Danville, PA 17822

132 Abigail Ln
Port Matilda, PA 16870
Phone (814) 272-5011

611 University Dr
State College, PA 16801
Phone (814) 234-2600

200 Scenery Dr
State College, PA 16801
Phone (814) 231-4560

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1191542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596067200000",
    "number": "1407044266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178224903",
            "telephone_number": "570-271-6144",
            "fax_number": "570-271-6578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 ABIGAIL LN",
            "city": "PORT MATILDA",
            "state": "PA",
            "postal_code": "168707153",
            "telephone_number": "814-272-7100",
            "fax_number": "814-272-6501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARPENTER",
        "first_name": "CHRISTINA",
        "middle_name": "R.",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-05",
        "last_updated": "2020-07-30",
        "certification_date": "2020-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA053180",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cciambotti84750@direct.geisinger.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "132 Abigail Ln",
            "city": "Port Matilda",
            "state": "PA",
            "country_code": "US",
            "postal_code": "168707153",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "CHRISTINA",
            "last_name": "SHAWVER",
            "middle_name": "R.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Port Matilda, PA

Sources for this page

Verify at the official NPI Registry.